Provider Demographics
NPI:1760520795
Name:ALLEN, DENISE D (PCC/LPC)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:D
Last Name:ALLEN
Suffix:
Gender:F
Credentials:PCC/LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8546 MEADVILLE RD
Mailing Address - Street 2:
Mailing Address - City:GIRARD
Mailing Address - State:PA
Mailing Address - Zip Code:16417-9216
Mailing Address - Country:US
Mailing Address - Phone:814-774-7106
Mailing Address - Fax:
Practice Address - Street 1:8546 MEADVILLE RD
Practice Address - Street 2:
Practice Address - City:GIRARD
Practice Address - State:PA
Practice Address - Zip Code:16417-9216
Practice Address - Country:US
Practice Address - Phone:814-774-7106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC0005359101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000306234OtherANTHEM BCBS