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General NPI Number Information
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NPI Number | 1366685661
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL COUNSELING CONSULTING & HUMAN SERVICES LLC
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Dates
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Enumeration Date | 04/16/2009
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 1 W CENTRE ST
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City | MAHANOY CITY
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State | PA
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Zip | 17948-2670
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Country | US
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Telephone | 570-622-9101
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Fax | 570-622-9102
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Provider Business Mailing Address
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Address Line | 1851 W END AVE
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City | POTTSVILLE
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State | PA
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Zip | 17901-2050
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Country | US
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Telephone | 570-622-9101
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Fax | 570-622-9102
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Authorized Official
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Title or Position | CEO
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Name | NADEEM BASHIR
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Credential | OWNER
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Telephone | 570-622-9101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 364SP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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