Provider Demographics
NPI:1982346011
Name:WARGO, GLENN (LPC)
Entity Type:Individual
Prefix:
First Name:GLENN
Middle Name:
Last Name:WARGO
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3505 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVER FALLS
Mailing Address - State:PA
Mailing Address - Zip Code:15010-3428
Mailing Address - Country:US
Mailing Address - Phone:724-510-7032
Mailing Address - Fax:
Practice Address - Street 1:8001 ROWAN RD STE 301
Practice Address - Street 2:
Practice Address - City:CRANBERRY TWP
Practice Address - State:PA
Practice Address - Zip Code:16066-3616
Practice Address - Country:US
Practice Address - Phone:724-510-7032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-09
Last Update Date:2022-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC014364101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPC014364OtherPA BOARD OF PROFESSIONAL AND OCCUPATIONAL AFFAIRS