Provider Demographics
NPI:1669944989
Name:MCCLOSKEY COUNSELING CENTER
Entity type:Organization
Organization Name:MCCLOSKEY COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-357-2400
Mailing Address - Street 1:PO BOX 8988
Mailing Address - Street 2:
Mailing Address - City:MILESBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16853-8988
Mailing Address - Country:US
Mailing Address - Phone:814-357-2400
Mailing Address - Fax:814-357-7740
Practice Address - Street 1:205 MILL ST
Practice Address - Street 2:
Practice Address - City:MILESBURG
Practice Address - State:PA
Practice Address - Zip Code:16853-3804
Practice Address - Country:US
Practice Address - Phone:814-357-2400
Practice Address - Fax:814-357-7740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-27
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018001520002Medicaid