| Organization Name: | NANTICOKE COUNSELING SERVICES PC |
| NPI Number: | 1831550599 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WILLIAM ROBERT KILLGORE (PRESIDENT/CEO) |
| Mailing Address: | 35 E Green St Nanticoke |
| State: | PA US |
| Postal Code: | 186342414 |
| Phone Number: | 5707622583 |
| Fax Number: | 5703002629 |
| NPI Enumeration Date: | 03/09/2016 |
| NPI Last Update Date: | 03/09/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | PC002979 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |