Healthcare Provider Details

I. General information

NPI: 1669155370
Provider Name (Legal Business Name): ANDREW S METCALF LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2023
Last Update Date: 08/09/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HAFT LANE
NEW ALBANY PA
18833-7880
US

IV. Provider business mailing address

1 HAFT LANE
NEW ALBANY PA
18833-7880
US

V. Phone/Fax

Practice location:
  • Phone: 570-363-2189
  • Fax:
Mailing address:
  • Phone: 570-363-2189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC003461
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: