Healthcare Provider Details

I. General information

NPI: 1780291062
Provider Name (Legal Business Name): GRASTA COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2020
Last Update Date: 02/02/2024
Certification Date: 02/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 BIDEN ST STE 502
SCRANTON PA
18503-1445
US

IV. Provider business mailing address

321 BIDEN ST STE 502
SCRANTON PA
18503-1445
US

V. Phone/Fax

Practice location:
  • Phone: 570-209-8946
  • Fax: 570-276-3797
Mailing address:
  • Phone: 570-209-8946
  • Fax: 570-276-3797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MARGARET M MAHONEY
Title or Position: COUNSELOR
Credential: LPC
Phone: 320-300-4811