Provider Demographics
NPI:1982200937
Name:MULTIPATH COUNSELING
Entity Type:Organization
Organization Name:MULTIPATH COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:LAVEROCK
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:724-977-9025
Mailing Address - Street 1:919 THERESA AVE
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-2808
Mailing Address - Country:US
Mailing Address - Phone:724-977-9025
Mailing Address - Fax:
Practice Address - Street 1:3755 E STATE ST # 5
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-3410
Practice Address - Country:US
Practice Address - Phone:724-977-9025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-07
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty