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General NPI Number Information
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NPI Number | 1427844398
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Entity Type | Individual
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Provider Name | CARISSA MICALE MS, NCC, LPC
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Gender | Female
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Dates
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Enumeration Date | 04/17/2025
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 317 ELK RUN AVE
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City | PUNXSUTAWNEY
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State | PA
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Zip | 15767-1621
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Country | US
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Telephone | 814-938-6340
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Fax |
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Provider Business Mailing Address
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Address Line | 29 DUTCHTOWN RD
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City | REYNOLDSVILLE
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State | PA
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Zip | 15851-5913
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Country | US
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Telephone | 814-227-9920
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC018494
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License Number State | PA
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