Healthcare Provider Details

I. General information

NPI: 1366326399
Provider Name (Legal Business Name): BLUE & WHITE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2025
Last Update Date: 08/04/2025
Certification Date: 08/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

541 BRITTANY DR
STATE COLLEGE PA
16803-1422
US

IV. Provider business mailing address

541 BRITTANY DR
STATE COLLEGE PA
16803-1422
US

V. Phone/Fax

Practice location:
  • Phone: 814-933-9116
  • Fax:
Mailing address:
  • Phone: 814-933-9116
  • 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: MARIA THERESIA HUBER
Title or Position: OWNER
Credential: LPC
Phone: 814-933-9116