Provider Demographics
NPI:1245779917
Name:PANE CONSULTING AND EDUCATION
Entity Type:Organization
Organization Name:PANE CONSULTING AND EDUCATION
Other - Org Name:PANE COUNSELING, CONSULTING, AND EDUCATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:PANE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:570-436-7022
Mailing Address - Street 1:8 W BROAD ST
Mailing Address - Street 2:SUITE 308
Mailing Address - City:HAZLETON
Mailing Address - State:PA
Mailing Address - Zip Code:18201-6424
Mailing Address - Country:US
Mailing Address - Phone:570-436-7022
Mailing Address - Fax:570-534-0997
Practice Address - Street 1:8 W BROAD ST
Practice Address - Street 2:SUITE 308
Practice Address - City:HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18201-6424
Practice Address - Country:US
Practice Address - Phone:570-436-7022
Practice Address - Fax:570-534-0997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-14
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0186131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1032400680001Medicaid