Provider Demographics
NPI:1336501923
Name:TWO ROADS COUNSELING SERVICES, INC
Entity Type:Organization
Organization Name:TWO ROADS COUNSELING SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROJECT AND FACILITY DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HALLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARLTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD LPC CAC
Authorized Official - Phone:814-952-8446
Mailing Address - Street 1:224 SHADY LN
Mailing Address - Street 2:
Mailing Address - City:PUNXSUTAWNEY
Mailing Address - State:PA
Mailing Address - Zip Code:15767-3370
Mailing Address - Country:US
Mailing Address - Phone:814-952-8446
Mailing Address - Fax:
Practice Address - Street 1:224 SHADY LN
Practice Address - Street 2:
Practice Address - City:PUNXSUTAWNEY
Practice Address - State:PA
Practice Address - Zip Code:15767-3370
Practice Address - Country:US
Practice Address - Phone:814-952-8446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-23
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA337112101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty