Provider Demographics
NPI:1154744936
Name:KELLY ANN DOWIAK PLLC
Entity type:Organization
Organization Name:KELLY ANN DOWIAK PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DOWIAK
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:724-591-2440
Mailing Address - Street 1:317 PINE WOOD DR
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-8524
Mailing Address - Country:US
Mailing Address - Phone:724-591-2440
Mailing Address - Fax:724-799-8871
Practice Address - Street 1:30 WARRENDALE BAYNE RD
Practice Address - Street 2:
Practice Address - City:WARRENDALE
Practice Address - State:PA
Practice Address - Zip Code:15086-7558
Practice Address - Country:US
Practice Address - Phone:724-591-2440
Practice Address - Fax:724-799-8871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-29
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006942101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty