Provider Demographics
NPI:1023227014
Name:PAUL J. TRIPOLI PC
Entity type:Organization
Organization Name:PAUL J. TRIPOLI PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:TRIPOLI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LPC, BCD
Authorized Official - Phone:724-747-9408
Mailing Address - Street 1:6 APPLE VALLEY RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-1216
Mailing Address - Country:US
Mailing Address - Phone:724-747-9408
Mailing Address - Fax:
Practice Address - Street 1:157 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-4948
Practice Address - Country:US
Practice Address - Phone:724-747-9408
Practice Address - Fax:724-229-8888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
BCD29462101Y00000X
PAPC001707101YP2500X
PACW0124841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA842145Medicare ID - Type Unspecified
PAS17917Medicare UPIN