Provider Demographics
NPI:1205353232
Name:CONNECTIONS COUNSELING OF WESTERN PENNSYLVANIA
Entity type:Organization
Organization Name:CONNECTIONS COUNSELING OF WESTERN PENNSYLVANIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:MARSILI
Authorized Official - Suffix:
Authorized Official - Credentials:MS, MDIV, LPC, BCC
Authorized Official - Phone:724-516-1569
Mailing Address - Street 1:236 WESTLAND DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-5946
Mailing Address - Country:US
Mailing Address - Phone:724-838-2128
Mailing Address - Fax:
Practice Address - Street 1:231 S MAIN ST STE 404
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-3115
Practice Address - Country:US
Practice Address - Phone:724-851-6156
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-30
Last Update Date:2017-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC009730261QM0855X
261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPC009730OtherSTATE LICENSE