Provider Demographics
NPI:1235813007
Name:SHAPING SUCCESSFUL FUTURES COUNSELING
Entity Type:Organization
Organization Name:SHAPING SUCCESSFUL FUTURES COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:KOHL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:814-923-3110
Mailing Address - Street 1:2820 W 21ST ST STE 201
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-2983
Mailing Address - Country:US
Mailing Address - Phone:814-923-3110
Mailing Address - Fax:813-212-0688
Practice Address - Street 1:2820 W 21ST ST STE 201
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-2983
Practice Address - Country:US
Practice Address - Phone:814-923-3110
Practice Address - Fax:813-212-0688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-12
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty