Healthcare Provider Details

I. General information

NPI: 1558341867
Provider Name (Legal Business Name): PEOPLE IN NEED-LAWRENCE COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2006
Last Update Date: 05/14/2013
Certification Date:
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: 724-657-3326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number400930
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number400930
License Number StatePA

VIII. Authorized Official

Name: MRS. GAYLE L KISSICK
Title or Position: MEDICAL OFFICE ADMINISTRATOR
Credential:
Phone: 724-657-3303