Provider Demographics
NPI:1699187229
Name:LAROCCO COUNSELING
Entity Type:Organization
Organization Name:LAROCCO COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROJECT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LAROCCO
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:814-946-5179
Mailing Address - Street 1:1218 PLEASANT VALLEY BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-4762
Mailing Address - Country:US
Mailing Address - Phone:814-946-5179
Mailing Address - Fax:814-946-5170
Practice Address - Street 1:1218 PLEASANT VALLEY BLVD STE C
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-4762
Practice Address - Country:US
Practice Address - Phone:814-946-5179
Practice Address - Fax:814-946-5170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-02
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA077031251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health