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General NPI Number Information
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NPI Number | 1710347513
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Entity Type | Organization
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Legal Business Name | CRISIS RECOVERY NETWORK
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Dates
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Enumeration Date | 03/07/2016
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Last Update Date | 03/07/2016
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Provider Practice Location Address
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Address Line | 419 RADCLIFFE DR
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City | HARRISBURG
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State | PA
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Zip | 17109-5459
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Country | US
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Telephone | 718-503-1309
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Fax |
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Provider Business Mailing Address
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Address Line | 419 RADCLIFFE DR
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City | HARRISBURG
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State | PA
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Zip | 17109-5459
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Country | US
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Telephone | 718-503-1309
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Fax |
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Authorized Official
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Title or Position | PROFESSIONAL COUNSELOR
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Name | KENNETH JOSEPH SUTTON
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Credential | LPC, CAADC
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Telephone | 718-503-1309
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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 | PC008745
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License Number State | PA
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