Provider Demographics
NPI:1588369037
Name:MUSSOLINE, MARIA CATHERINE (LPC, NCC, MA)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:CATHERINE
Last Name:MUSSOLINE
Suffix:
Gender:F
Credentials:LPC, NCC, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 CRYSTAL LN
Mailing Address - Street 2:
Mailing Address - City:ROYERSFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19468-2292
Mailing Address - Country:US
Mailing Address - Phone:717-512-3527
Mailing Address - Fax:
Practice Address - Street 1:645 PENN ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19601-3543
Practice Address - Country:US
Practice Address - Phone:610-373-4281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-04
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC015439101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional