Provider Demographics
NPI:1033660238
Name:KEYSTONE COUNSELING & SOCIAL SERVICES LLC
Entity Type:Organization
Organization Name:KEYSTONE COUNSELING & SOCIAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBERS
Authorized Official - Prefix:
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SZABO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:724-317-2139
Mailing Address - Street 1:113 MEMORIAL ST
Mailing Address - Street 2:
Mailing Address - City:DUNBAR
Mailing Address - State:PA
Mailing Address - Zip Code:15431-1621
Mailing Address - Country:US
Mailing Address - Phone:724-317-2139
Mailing Address - Fax:
Practice Address - Street 1:130 WOODLAND CT STE 1
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15417-9383
Practice Address - Country:US
Practice Address - Phone:724-317-2139
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-23
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0181121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1447688957OtherPERSONAL NPI