Provider Demographics
NPI:1740221076
Name:ALLENBAUGH, WILLIAM GEORGE II (MA CAC LICENSED PSYC)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:GEORGE
Last Name:ALLENBAUGH
Suffix:II
Gender:M
Credentials:MA CAC LICENSED PSYC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 MCCRACKEN RUN RD
Mailing Address - Street 2:
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801
Mailing Address - Country:US
Mailing Address - Phone:814-371-5565
Mailing Address - Fax:814-371-5679
Practice Address - Street 1:170 MCCRACKEN RUN RD
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801
Practice Address - Country:US
Practice Address - Phone:814-371-5565
Practice Address - Fax:814-371-5679
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS007390L103T00000X, 103TA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA774789Medicaid
PA488871OtherHIGH MARK