Healthcare Provider Details

I. General information

NPI: 1952678930
Provider Name (Legal Business Name): CHRISTINA PUCEL LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/19/2011
Last Update Date: 03/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416 W MAIN ST
MONONGAHELA PA
15063-2552
US

IV. Provider business mailing address

6086 BROWNSVILLE ROAD EXT
FINLEYVILLE PA
15332-4121
US

V. Phone/Fax

Practice location:
  • Phone: 724-986-0479
  • Fax:
Mailing address:
  • Phone: 724-986-0479
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC006077
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: