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General NPI Number Information
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NPI Number | 1982092003
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Entity Type | Organization
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Legal Business Name | THE COUCH, LLC
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Dates
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Enumeration Date | 12/23/2014
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Last Update Date | 12/23/2014
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Provider Practice Location Address
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Address Line | 208 S ARCH ST SUITE 5
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City | CONNELLSVILLE
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State | PA
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Zip | 15425-3519
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Country | US
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Telephone | 724-322-5178
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Fax | 724-603-2503
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Provider Business Mailing Address
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Address Line | 208 S ARCH ST SUITE 5
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City | CONNELLSVILLE
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State | PA
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Zip | 15425-3519
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Country | US
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Telephone | 724-322-5178
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Fax | 724-603-2503
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Authorized Official
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Title or Position | OWNER
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Name | ANDREW J LOY
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Credential | LPC, NCC
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Telephone | 724-322-5178
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | PC006230
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License Number State | PA
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