Provider Demographics
NPI:1578695060
Name:FAMILY COUNSELING CENTER OF ARMSTRONG COUNTY
Entity Type:Organization
Organization Name:FAMILY COUNSELING CENTER OF ARMSTRONG COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAEFFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-543-2941
Mailing Address - Street 1:300 S JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:KITTANNING
Mailing Address - State:PA
Mailing Address - Zip Code:16201-2416
Mailing Address - Country:US
Mailing Address - Phone:724-543-2941
Mailing Address - Fax:724-543-4177
Practice Address - Street 1:321 STATE ROUTE 66
Practice Address - Street 2:
Practice Address - City:LEECHBURG
Practice Address - State:PA
Practice Address - Zip Code:15656-8279
Practice Address - Country:US
Practice Address - Phone:724-845-6667
Practice Address - Fax:724-845-2533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-10
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA401290251S00000X
PA448280251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA448280Medicaid
PA1971913OtherPREMIER BLUE NETWORK
PA1971917OtherKHPW
PA1007566420032Medicaid
PA448280Medicaid