Provider Demographics
NPI:1659664258
Name:COUNSELING AND TRAUMA SERVICES LLC
Entity Type:Organization
Organization Name:COUNSELING AND TRAUMA SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAULINE
Authorized Official - Middle Name:
Authorized Official - Last Name:AMAISMEIER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, NCC, RN-BC, DCC
Authorized Official - Phone:724-263-8883
Mailing Address - Street 1:40 ROBIN DR
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:PA
Mailing Address - Zip Code:15340-1501
Mailing Address - Country:US
Mailing Address - Phone:725-263-8883
Mailing Address - Fax:724-356-2787
Practice Address - Street 1:8 FOUR COINS DR
Practice Address - Street 2:
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317-1769
Practice Address - Country:US
Practice Address - Phone:724-579-3771
Practice Address - Fax:724-356-2787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-16
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005009101YP2500X
PARN258900L163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)Group - Multi-Specialty