Provider Demographics
NPI:1801006564
Name:PHLEGER, LAWRENCE WARREN (LPC)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:WARREN
Last Name:PHLEGER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 2ND ST
Mailing Address - Street 2:
Mailing Address - City:BROOKVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15825-1556
Mailing Address - Country:US
Mailing Address - Phone:814-849-2844
Mailing Address - Fax:814-849-3425
Practice Address - Street 1:23 BEAVER DR
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-2443
Practice Address - Country:US
Practice Address - Phone:814-371-1088
Practice Address - Fax:814-371-4966
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC002047101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional