1790330405 NPI number — LAURA ROSE SCHWOB NCC, LPC, M.ED.

Table of content: LAURA ROSE SCHWOB NCC, LPC, M.ED. (NPI 1790330405)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790330405 NPI number — LAURA ROSE SCHWOB NCC, LPC, M.ED.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHWOB
Provider First Name:
LAURA
Provider Middle Name:
ROSE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
NCC, LPC, M.ED.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SCHWOB
Provider Other First Name:
LAURA
Provider Other Middle Name:
ROSE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1790330405
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/12/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
ASSOCIATES IN COUNSELING AND WELLNESS
Provider Second Line Business Mailing Address:
2001 WATERDAM PLAZA DRIVE,SUITE 206
Provider Business Mailing Address City Name:
MCMURRAY
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15317
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-559-9152
Provider Business Mailing Address Fax Number:
724-969-4170

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2001 WATERDAM PLAZA DR STE 206
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MC MURRAY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15317-5416
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-559-9152
Provider Business Practice Location Address Fax Number:
724-969-4170
Provider Enumeration Date:
08/08/2019

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  PC011638 , 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)





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