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General NPI Number Information
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NPI Number | 1336501923
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Entity Type | Organization
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Legal Business Name | TWO ROADS COUNSELING SERVICES, INC
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Dates
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Enumeration Date | 03/23/2016
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Last Update Date | 03/23/2016
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Provider Practice Location Address
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Address Line | 224 SHADY LN
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City | PUNXSUTAWNEY
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State | PA
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Zip | 15767-3370
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Country | US
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Telephone | 814-952-8446
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Fax |
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Provider Business Mailing Address
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Address Line | 224 SHADY LN
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City | PUNXSUTAWNEY
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State | PA
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Zip | 15767-3370
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Country | US
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Telephone | 814-952-8446
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Fax |
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Authorized Official
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Title or Position | PROJECT AND FACILITY DIRECTOR
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Name | DR. HALLIE CARLTON
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Credential | PHD LPC CAC
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Telephone | 814-952-8446
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 337112
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License Number State | PA
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