Healthcare Provider Details

I. General information

NPI: 1831093129
Provider Name (Legal Business Name): PROFESSIONAL COUNSELING SERVICES OF NEPA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

616 MYRTLE ST
SCRANTON PA
18510-1034
US

IV. Provider business mailing address

415 BIDEN ST
SCRANTON PA
18503-1803
US

V. Phone/Fax

Practice location:
  • Phone: 570-278-3145
  • Fax:
Mailing address:
  • Phone: 724-278-3145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. ALEX HAZZOURI
Title or Position: PRESIDENT & CHIEF EXECUTIVE OFFICER
Credential:
Phone: 570-510-1338