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General NPI Number Information
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NPI Number | 1649728726
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Entity Type | Organization
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Legal Business Name | FORENSIC COUNSELING SERIVES
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Dates
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Enumeration Date | 09/16/2016
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Last Update Date | 09/16/2016
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Provider Practice Location Address
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Address Line | 3664 ROUTE 30
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City | LATROBE
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State | PA
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Zip | 15650-5208
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Country | US
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Telephone | 724-309-8083
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Fax | 724-539-1555
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Provider Business Mailing Address
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Address Line | 3664 ROUTE 30
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City | LATROBE
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State | PA
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Zip | 15650-5208
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STACEY D FRYE-KERR
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Credential | LSW
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Telephone | 724-309-8083
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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 | SW129596
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License Number State | PA
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