Alliance Counseling LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

PC007371 Issued in PA

Legal business name

ALLIANCE COUNSELING LLC

Practice address

2639 River Rd
Vandergrift, PA 15690-6105

Phone

(724) 351-0585

NPI assigned

Jan 19, 2018

Last updated

Jun 16, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Fawn M Clark, MA, NCC, LPCNPI 1205159779

Title

Therapist

Phone

(724) 351-0585

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Fawn M. Clark

  • Mental Health Counselor
  • New Kensington, PA
  • NPI 1205159779
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1516320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1780192161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2639 RIVER RD",
            "city": "VANDERGRIFT",
            "state": "PA",
            "postal_code": "156906105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2639 RIVER RD",
            "city": "VANDERGRIFT",
            "state": "PA",
            "postal_code": "156906105",
            "telephone_number": "724-351-0585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLIANCE COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-19",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "FAWN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "724-351-0585",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA, NCC, LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "PC007371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Vandergrift, PA
• Providers in Vandergrift, PA by specialty
• Mental Health Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.