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General NPI Number Information
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NPI Number | 1538010350
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Entity Type | Individual
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Provider Name | DYLAN COSTELLO
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Gender | Male
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Dates
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Enumeration Date | 02/06/2026
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Last Update Date | 02/06/2026
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Provider Practice Location Address
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Address Line | 706 BLOOM RD
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City | DANVILLE
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State | PA
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Zip | 17821-1367
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Country | US
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Telephone | 570-259-4388
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Fax |
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Provider Business Mailing Address
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Address Line | 204 RAINBOW HILL RD
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City | BENTON
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State | PA
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Zip | 17814-8120
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Country | US
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Telephone | 570-472-8187
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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 | APC002129
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License Number State | PA
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