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General NPI Number Information
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NPI Number | 1497192363
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Entity Type | Organization
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Legal Business Name | COUNSELING AND ASSESSMENT SERVICES
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Dates
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Enumeration Date | 05/31/2013
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Last Update Date | 05/31/2013
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Provider Practice Location Address
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Address Line | 1363 W 6TH ST
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City | ERIE
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State | PA
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Zip | 16505-2559
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Country | US
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Telephone | 814-490-4740
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Fax | 814-455-0754
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Provider Business Mailing Address
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Address Line | 1363 W 6TH ST
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City | ERIE
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State | PA
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Zip | 16505-2559
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Country | US
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Telephone | 814-490-4740
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Fax | 814-455-0754
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Authorized Official
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Title or Position | OWNER/PSYCHOLOGIST
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Name | DR. ROBERT R. IDDINGS
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Credential | PH. D.
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Telephone | 814-490-4740
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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 | PC005995
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PS016557L
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License Number State | PA
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