Healthcare Provider Details

I. General information

NPI: 1063282838
Provider Name (Legal Business Name): PHILIP ANDREW SUNSERI LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2024
Last Update Date: 01/09/2024
Certification Date: 01/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2703 W STATE ST
NEW CASTLE PA
16101-8645
US

IV. Provider business mailing address

2703 W STATE ST
NEW CASTLE PA
16101-8645
US

V. Phone/Fax

Practice location:
  • Phone: 724-657-3303
  • Fax: 724-657-3326
Mailing address:
  • Phone: 724-657-3303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC016592
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: