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General NPI Number Information
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NPI Number | 1598829616
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Entity Type | Organization
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Legal Business Name | LAKE ERIE COUNSELING INC
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 07/10/2015
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Provider Practice Location Address
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Address Line | 301 WEST 10TH STREET
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City | ERIE
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State | PA
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Zip | 16502-1440
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Country | US
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Telephone | 814-455-4009
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Fax | 814-455-7715
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Provider Business Mailing Address
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Address Line | 301 WEST 10TH STREET
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City | ERIE
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State | PA
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Zip | 16502-1440
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Country | US
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Telephone | 814-455-4009
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Fax | 814-455-7715
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DALE ANTHONY ALLGEIER
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Credential | LCSW
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Telephone | 814-455-4009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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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 #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW7163L
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License Number State | PA
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