1376914978 NPI number — Y COUNSELING LLC

Table of content: (NPI 1376914978)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376914978 NPI number — Y COUNSELING LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Y COUNSELING LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1376914978
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/15/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
217 UNION AVE
Provider Second Line Business Mailing Address:
2ND FLOOR
Provider Business Mailing Address City Name:
ALTOONA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16602-3247
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-515-9020
Provider Business Mailing Address Fax Number:
844-228-0544

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
217 UNION AVE
Provider Second Line Business Practice Location Address:
2ND FLOOR
Provider Business Practice Location Address City Name:
ALTOONA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16602-3247
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-515-9020
Provider Business Practice Location Address Fax Number:
844-228-0544
Provider Enumeration Date:
10/08/2015

Additional Information

Authorized Official

Authorized Official Last Name:
YASOLSKY
Authorized Official First Name:
HEATHER
Authorized Official Middle Name:
L
Authorized Official Title or Position:
OWNER/COUNSELOR
Authorized Official Telephone Number:
814-207-9552

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  PC001766 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1245439884 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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