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General NPI Number Information
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NPI Number | 1942429758
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL ALLIANCE OF COUNSELORS AND THERAPISTS, INC.
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1327 S 18TH ST
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City | NEW CASTLE
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State | IN
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Zip | 47362-2665
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Country | US
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Telephone | 765-529-7071
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Fax | 765-529-5612
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Provider Business Mailing Address
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Address Line | 1327 S 18TH ST
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City | NEW CASTLE
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State | IN
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Zip | 47362-2665
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Country | US
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Telephone | 765-529-7071
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Fax | 765-529-5612
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Authorized Official
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Title or Position | PRESIDENT, PACT, INC.
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Name | MR. RICHARD MARCUS ROGERS
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Credential | LCSW
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Telephone | 765-529-7071
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 34002700A
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License Number State | IN
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