Provider Demographics
NPI:1508801887
Name:PAOLETTA COUNSELING SERVICES, INC
Entity Type:Organization
Organization Name:PAOLETTA COUNSELING SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:R
Authorized Official - Last Name:HANAWAY
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:724-662-7202
Mailing Address - Street 1:456 N PITT ST
Mailing Address - Street 2:
Mailing Address - City:MERCER
Mailing Address - State:PA
Mailing Address - Zip Code:16137-1129
Mailing Address - Country:US
Mailing Address - Phone:724-662-7202
Mailing Address - Fax:
Practice Address - Street 1:456 N PITT ST
Practice Address - Street 2:
Practice Address - City:MERCER
Practice Address - State:PA
Practice Address - Zip Code:16137-1129
Practice Address - Country:US
Practice Address - Phone:724-662-7202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 103TS0200X, 1041C0700X, 261Q00000X
PA437940251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA437940OtherNEW STATE LICENSE
PA001815290Medicaid
PA081799Medicare ID - Type Unspecified