Provider Demographics
NPI:1609638410
Name:METANOIA COUNSELING & PROFESSIONAL DEVELOPMENT SERVICES LLC
Entity Type:Organization
Organization Name:METANOIA COUNSELING & PROFESSIONAL DEVELOPMENT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:KERI
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:814-923-9374
Mailing Address - Street 1:2438 PALERMO CIR
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-7208
Mailing Address - Country:US
Mailing Address - Phone:814-923-9374
Mailing Address - Fax:
Practice Address - Street 1:2438 PALERMO CIR
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-7208
Practice Address - Country:US
Practice Address - Phone:814-480-0777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty