Provider Demographics
NPI:1831599588
Name:OAZA COUNSELING, LC
Entity type:Organization
Organization Name:OAZA COUNSELING, LC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:PRUSHINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:570-933-5325
Mailing Address - Street 1:123 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GIRARDVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17935-1718
Mailing Address - Country:US
Mailing Address - Phone:570-933-5325
Mailing Address - Fax:570-276-2098
Practice Address - Street 1:123 W MAIN ST
Practice Address - Street 2:
Practice Address - City:GIRARDVILLE
Practice Address - State:PA
Practice Address - Zip Code:17935-1718
Practice Address - Country:US
Practice Address - Phone:570-933-5325
Practice Address - Fax:570-276-2098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-01
Last Update Date:2014-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006669101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1548552573OtherNPI