Provider Demographics
NPI:1639544489
Name:PYLE, PATRICIA MARY (CADC,CCDP,CCJP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:MARY
Last Name:PYLE
Suffix:
Gender:F
Credentials:CADC,CCDP,CCJP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2723 READING BLVD.
Mailing Address - Street 2:
Mailing Address - City:WEAT LAWN.
Mailing Address - State:PA
Mailing Address - Zip Code:19609
Mailing Address - Country:US
Mailing Address - Phone:610-678-0193
Mailing Address - Fax:
Practice Address - Street 1:2723 READING BLVD.
Practice Address - Street 2:
Practice Address - City:WEST LAWN
Practice Address - State:PA
Practice Address - Zip Code:19609
Practice Address - Country:US
Practice Address - Phone:610-678-0193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-04
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NONE101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)