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General NPI Number Information
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NPI Number | 1659664258
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Entity Type | Organization
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Legal Business Name | COUNSELING AND TRAUMA SERVICES LLC
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Dates
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Enumeration Date | 05/16/2011
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Last Update Date | 05/16/2011
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Provider Practice Location Address
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Address Line | 8 FOUR COINS DR
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City | CANONSBURG
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State | PA
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Zip | 15317-1769
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Country | US
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Telephone | 724-579-3771
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Fax | 724-356-2787
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Provider Business Mailing Address
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Address Line | 40 ROBIN DR
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City | HICKORY
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State | PA
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Zip | 15340-1501
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Country | US
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Telephone | 725-263-8883
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Fax | 724-356-2787
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Authorized Official
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Title or Position | OWNER
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Name | PAULINE AMAISMEIER
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Credential | LPC, NCC, RN-BC, DCC
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Telephone | 724-263-8883
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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 | PC005009
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 163WA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Registered Nurse
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License Number | RN258900L
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License Number State | PA
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