Provider Demographics
NPI:1598518110
Name:PATRICIA ANN CANTRELL DBA PAC CHRISTIAN COUNSELING SERVICE. LLC
Entity Type:Organization
Organization Name:PATRICIA ANN CANTRELL DBA PAC CHRISTIAN COUNSELING SERVICE. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:CANTRELL
Authorized Official - Suffix:
Authorized Official - Credentials:BMHC
Authorized Official - Phone:717-773-5371
Mailing Address - Street 1:120 SAINT ANDREWS WAY
Mailing Address - Street 2:
Mailing Address - City:ETTERS
Mailing Address - State:PA
Mailing Address - Zip Code:17319-9431
Mailing Address - Country:US
Mailing Address - Phone:717-773-5371
Mailing Address - Fax:
Practice Address - Street 1:120 SAINT ANDREWS WAY
Practice Address - Street 2:
Practice Address - City:ETTERS
Practice Address - State:PA
Practice Address - Zip Code:17319-9431
Practice Address - Country:US
Practice Address - Phone:717-773-5371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-11
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty