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General NPI Number Information
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NPI Number | 1346786241
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Entity Type | Organization
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Legal Business Name | THE FAMILY STUDY LLC
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Dates
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Enumeration Date | 01/16/2017
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Last Update Date | 01/16/2017
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Provider Practice Location Address
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Address Line | 101 N MAIN ST
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City | GREENSBURG
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State | PA
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Zip | 15601-2403
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Country | US
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Telephone | 724-858-8385
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Fax |
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Provider Business Mailing Address
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Address Line | 610 CLEVELAND ST
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City | GREENSBURG
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State | PA
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Zip | 15601-2704
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Country | US
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Telephone | 724-858-8285
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DAVID DEWITT
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Credential | LMFT, LPC
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Telephone | 724-858-8385
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | PC004963
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MF000633
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License Number State | PA
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