Provider Demographics
NPI: | 1124435458 |
---|---|
Name: | ARIANNE SCHELLER COUNSELING |
Entity type: | Organization |
Organization Name: | ARIANNE SCHELLER COUNSELING |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | ARIANNE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | SCHELLER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | PHD, LPC |
Authorized Official - Phone: | 570-498-9326 |
Mailing Address - Street 1: | 602 BIRCH ST |
Mailing Address - Street 2: | |
Mailing Address - City: | SCRANTON |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 18505-4240 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 570-498-9326 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 3 W OLIVE ST |
Practice Address - Street 2: | |
Practice Address - City: | SCRANTON |
Practice Address - State: | PA |
Practice Address - Zip Code: | 18508-2572 |
Practice Address - Country: | US |
Practice Address - Phone: | 570-498-9326 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2014-07-18 |
Last Update Date: | 2017-05-02 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
PA | PC005886 | 101YM0800X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Single Specialty |