Provider Demographics
NPI:1053723759
Name:NEIGHBORHOOD COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:NEIGHBORHOOD COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:724-996-6321
Mailing Address - Street 1:16265 CONNEAUT LAKE RD
Mailing Address - Street 2:SUITE 1391
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-3861
Mailing Address - Country:US
Mailing Address - Phone:724-456-8614
Mailing Address - Fax:
Practice Address - Street 1:16265 CONNEAUT LAKE RD
Practice Address - Street 2:SUITE 1391
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-3861
Practice Address - Country:US
Practice Address - Phone:724-456-8614
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-29
Last Update Date:2014-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-006232-L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty