Organization Name: | KEYSTONE COUNSELING SERVICES, PC |
NPI Number: | 1689775157 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WILLIAM J KELLY (PRESIDENT) |
Mailing Address: | 343 S 3rd St Coopersburg |
State: | PA US |
Postal Code: | 180362111 |
Phone Number: | 6102822575 |
Fax Number: | 6102823076 |
NPI Enumeration Date: | 09/26/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC1900X |
License Number: | PS-002722-L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Counseling |
Taxonomy Definition: |