Provider Demographics
NPI:1447601711
Name:MOBILE COUNSELING ASSOCIATES LIMITED LIABILITY COMPANY
Entity Type:Organization
Organization Name:MOBILE COUNSELING ASSOCIATES LIMITED LIABILITY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:814-673-4189
Mailing Address - Street 1:173 AIRES HILL RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:PA
Mailing Address - Zip Code:16323-7801
Mailing Address - Country:US
Mailing Address - Phone:814-673-4189
Mailing Address - Fax:814-209-0093
Practice Address - Street 1:173 AIRES HILL RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:PA
Practice Address - Zip Code:16323-7801
Practice Address - Country:US
Practice Address - Phone:814-673-4189
Practice Address - Fax:814-209-0093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-28
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health