Provider Demographics
NPI:1063954675
Name:AGOSTONI, RONALD (LPC, MS, MS)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:
Last Name:AGOSTONI
Suffix:
Gender:M
Credentials:LPC, MS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW EAGLE
Mailing Address - State:PA
Mailing Address - Zip Code:15067-1148
Mailing Address - Country:US
Mailing Address - Phone:412-302-7170
Mailing Address - Fax:724-863-8320
Practice Address - Street 1:8320 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:NORTH HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:15642-2719
Practice Address - Country:US
Practice Address - Phone:724-863-7223
Practice Address - Fax:724-863-8320
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-14
Last Update Date:2016-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC009312101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional