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NPI Code Detail

MEDICARE: MR. BRIAN EMERSON DICK LPC

MEDICARE:  MR. BRIAN EMERSON DICK  LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorPC002175PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
17246685OTHERPAAETNA
21669967OTHERPAHIGHMARK KHPW

General Provider Information

NPI Number : 1720129463
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRIAN EMERSON DICK LPC
Provider Business Mailing Address
First Line : 21 QUINTER RD
Second Line :
City : HADLEY
State : PA
Zip : 16130-1417
Country : US
Telephone Number : 724-284-9440
Fax Number : 724-284-9441
Provider Business Practice Location Address
First Line : 100 BRUGH AVE
Second Line :
City : BUTLER
State : PA
Zip : 16001-6410
Country : US
Telephone Number : 724-284-9440
Fax Number : 724-284-9441
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2007
Last Update Date : 07/08/2007

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Directions to “ MR. BRIAN EMERSON DICK LPC” Practice Location

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