Provider Demographics
NPI:1033523576
Name:SOCCIO, KATHLEEN E (BSL, LPC)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:E
Last Name:SOCCIO
Suffix:
Gender:F
Credentials:BSL, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1521 WASHINGTON BOULVARD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-5426
Mailing Address - Country:US
Mailing Address - Phone:570-322-5051
Mailing Address - Fax:570-322-6788
Practice Address - Street 1:1521 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-5426
Practice Address - Country:US
Practice Address - Phone:570-322-5051
Practice Address - Fax:570-322-6788
Is Sole Proprietor?:No
Enumeration Date:2014-06-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH001581101YM0800X
PAPC009427101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health