Provider Demographics
NPI:1114572682
Name:FRANK, CARLY RAE (LPC)
Entity Type:Individual
Prefix:
First Name:CARLY
Middle Name:RAE
Last Name:FRANK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 SHENANGO AVE
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146-1503
Mailing Address - Country:US
Mailing Address - Phone:814-455-5505
Mailing Address - Fax:814-455-5515
Practice Address - Street 1:650 EAST AVE
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16503-1535
Practice Address - Country:US
Practice Address - Phone:814-455-5505
Practice Address - Fax:814-455-5515
Is Sole Proprietor?:No
Enumeration Date:2019-08-01
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PC011166101YM0800X
PAPC011166101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health