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General NPI Number Information
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NPI Number | 1609984343
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Entity Type | Organization
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Legal Business Name | ST ANTHONYS POINT INC
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 05/13/2013
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Provider Practice Location Address
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Address Line | 3679 E STATE ST
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City | HERMITAGE
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State | PA
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Zip | 16148-3411
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Country | US
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Telephone | 724-982-0414
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Fax | 724-982-4407
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Provider Business Mailing Address
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Address Line | 3679 E STATE ST
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City | HERMITAGE
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State | PA
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Zip | 16148-3411
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Country | US
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Telephone | 724-982-0414
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Fax | 724-982-4407
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Authorized Official
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Title or Position | PSYCHOLOGIST OWNER
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Name | DEBORAH J MIKITA
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Credential | MA
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Telephone | 724-982-0414
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | SW128655
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC006662
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | PS008073L
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | PS008073L
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License Number State | PA
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Taxonomy #5
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | PC005176
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License Number State |
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Taxonomy #6
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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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