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General NPI Number Information
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NPI Number | 1073457560
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Entity Type | Organization
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Legal Business Name | MOUNTAIN LAUREL COUNSELING, LLC
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Dates
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Enumeration Date | 04/16/2026
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Last Update Date | 04/16/2026
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Provider Practice Location Address
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Address Line | 629 E DRINKER ST STE 1
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City | DUNMORE
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State | PA
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Zip | 18512-2549
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Country | US
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Telephone | 570-561-5894
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Fax |
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Provider Business Mailing Address
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Address Line | 304 GRANDVIEW ST
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City | CLARKS SUMMIT
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State | PA
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Zip | 18411-2014
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Country | US
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Telephone | 570-561-5894
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | SUSAN E WILKERSON
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Credential | MS, NCC, LPC
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Telephone | 570-561-5894
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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