Provider Demographics
NPI:1265230395
Name:LANCE, KATELYN MARIE (MA, MED, LAPC)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:MARIE
Last Name:LANCE
Suffix:
Gender:F
Credentials:MA, MED, LAPC
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:MARIE
Other - Last Name:ECKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:35 POINT ST
Mailing Address - Street 2:
Mailing Address - City:BLAIRSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15717-9640
Mailing Address - Country:US
Mailing Address - Phone:814-397-5408
Mailing Address - Fax:
Practice Address - Street 1:665 PHILADELPHIA ST STE 202
Practice Address - Street 2:
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-3941
Practice Address - Country:US
Practice Address - Phone:724-465-2605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAPC000952101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)