Provider Demographics
NPI:1659368157
Name:MCCULLOUGH-CRISSMAN, JOAN E (LPC)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:E
Last Name:MCCULLOUGH-CRISSMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:JOAN
Other - Middle Name:E
Other - Last Name:MCCULLOUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:189 TOLLGATE HILL RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-6206
Mailing Address - Country:US
Mailing Address - Phone:724-972-6409
Mailing Address - Fax:724-519-8463
Practice Address - Street 1:4578 WILLIAM PENN HWY
Practice Address - Street 2:
Practice Address - City:MURRYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15668-2002
Practice Address - Country:US
Practice Address - Phone:724-972-6409
Practice Address - Fax:724-519-8463
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-30
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health