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General NPI Number Information
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NPI Number | 1386916435
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Entity Type | Organization
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Legal Business Name | CONNELLSVILLE COUNSELING CENTER, INC
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Dates
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Enumeration Date | 02/06/2012
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Last Update Date | 02/06/2012
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Provider Practice Location Address
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Address Line | 110 S ARCH ST
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City | CONNELLSVILLE
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State | PA
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Zip | 15425-3515
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Country | US
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Telephone | 724-626-9941
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Fax | 724-626-2785
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Provider Business Mailing Address
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Address Line | 110 S ARCH ST
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City | CONNELLSVILLE
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State | PA
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Zip | 15425-3515
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Country | US
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Telephone | 724-626-9941
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Fax | 724-626-2785
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Authorized Official
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Title or Position | CEO
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Name | CAROLE G STERN
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Credential | MS, RN-BC
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Telephone | 724-626-9941
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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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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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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 | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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