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General NPI Number Information
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NPI Number | 1346602356
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Entity Type | Organization
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Legal Business Name | PIVOTAL POINTE, LLC
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Dates
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Enumeration Date | 03/28/2016
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Last Update Date | 03/28/2016
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Provider Practice Location Address
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Address Line | 9048 WILLIAM PENN HWY SUITE 4
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City | HUNTINGDON
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State | PA
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Zip | 16652-6966
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Country | US
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Telephone | 814-515-6220
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Fax |
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Provider Business Mailing Address
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Address Line | 6997 KETTLE RD
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City | TYRONE
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State | PA
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Zip | 16686-6561
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Country | US
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Telephone | 814-515-6220
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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 | MS. NICOLE ENDRESS
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Credential | NCC, LPC
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Telephone | 814-515-6220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | PC008861
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License Number State | PA
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