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General NPI Number Information
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NPI Number | 1780898478
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Entity Type | Individual
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Provider Name | MITCHELL VALBURG LPC
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Gender | Male
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 06/08/2021
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Provider Practice Location Address
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Address Line | 421 S STATE ST
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City | CLARKS SUMMIT
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State | PA
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Zip | 18411-1684
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Country | US
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Telephone | 570-877-3140
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Fax | 570-253-8242
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Provider Business Mailing Address
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Address Line | 209 ASHMORE AVE
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City | CLARKS SUMMIT
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State | PA
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Zip | 18411-1562
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Country | US
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Telephone | 570-877-3140
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Fax | 570-253-8242
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 004492
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | PC004492
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 004492
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License Number State | PA
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