MEDICARE: UNGLAUB COUNSELING LLC

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
1	101YM0800X	Mental Health Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PC012906	OTHER	PA	STATE LICENSE

General Provider Information

NPI Number	:	1801597216
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNGLAUB COUNSELING LLC

Provider Business Mailing Address
First Line	:	11110 CENTER HWY STE 6
Second Line	:
City	:	IRWIN
State	:	PA
Zip	:	15642-2084
Country	:	US
Telephone Number	:	724-552-8892
Fax Number	:

Provider Business Practice Location Address
First Line	:	11110 CENTER HWY STE 6
Second Line	:
City	:	IRWIN
State	:	PA
Zip	:	15642-2084
Country	:	US
Telephone Number	:	412-655-4362
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ANDREA UNGLAUB
Credential	:
Telephone Number	:	724-552-8892

Provider Enumeration Date	:	03/13/2023
Last Update Date	:	02/05/2024

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