Healthcare Provider Details

I. General information

NPI: 1063956167
Provider Name (Legal Business Name): MARY REGETS WORKMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/07/2016
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2652 HIDDEN VALLEY RD STE 303A
UPPER ST CLAIR PA
15241-3915
US

IV. Provider business mailing address

52 STONE MARKER DR
WASHINGTON PA
15301-2746
US

V. Phone/Fax

Practice location:
  • Phone: 724-825-4914
  • Fax:
Mailing address:
  • Phone: 724-825-4914
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC 008364
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: