Healthcare Provider Details

I. General information

NPI: 1326462599
Provider Name (Legal Business Name): INTEGRATIVE COUNSELING SERVICES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2014
Last Update Date: 04/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 MULBERRY ST SUITE 201
SCRANTON PA
18503-1225
US

IV. Provider business mailing address

300 MULBERRY ST SUITE 201
SCRANTON PA
18503-1225
US

V. Phone/Fax

Practice location:
  • Phone: 570-955-5479
  • Fax:
Mailing address:
  • Phone: 570-955-5479
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: ALYSE MARIE KERR
Title or Position: PRESIDENT/CEO
Credential: MS NCC NADD-CC LPC
Phone: 570-955-5479