=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467037770
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ART, PLAY & ORR COUNSELING SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/17/2021
-----------------------------------------------------
Last Update Date | 03/17/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3910 CAUGHEY RD
-----------------------------------------------------
City | ERIE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16506-4096
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 814-732-9366
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 115 E NORMAL ST
-----------------------------------------------------
City | EDINBORO
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16412-2512
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 814-873-3092
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. PENELOPE ORR
-----------------------------------------------------
Credential | LPC
-----------------------------------------------------
Telephone | 814-723-9366
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------