Provider Demographics
NPI:1528058864
Name:FAMILY COUNSELING CENTER OF ARMSTRONG COUNTY
Entity type:Organization
Organization Name:FAMILY COUNSELING CENTER OF ARMSTRONG COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAEFFER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:724-543-2941
Mailing Address - Street 1:300 S JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:KITTANNING
Mailing Address - State:PA
Mailing Address - Zip Code:16201-2416
Mailing Address - Country:US
Mailing Address - Phone:724-543-2941
Mailing Address - Fax:724-543-4177
Practice Address - Street 1:300 S JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201-2416
Practice Address - Country:US
Practice Address - Phone:724-543-2941
Practice Address - Fax:724-543-4177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-27
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA401290251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA114068Medicaid
PA1020375OtherCBHNP GTW MEDICARE
PACL7502OtherMEDICARE RAILROAD PART B
PA1007566420036Medicaid
PA275143OtherKHPW #
PA658496Medicaid
PACL7502OtherMEDICARE RAILROAD PART B