Provider Demographics
NPI:1255575346
Name:SYNERGY COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:SYNERGY COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:MA, ATR-BC, LPC
Authorized Official - Phone:570-875-2271
Mailing Address - Street 1:935 CENTRE ST
Mailing Address - Street 2:PO BOX 406
Mailing Address - City:ASHLAND
Mailing Address - State:PA
Mailing Address - Zip Code:17921-1243
Mailing Address - Country:US
Mailing Address - Phone:570-875-2271
Mailing Address - Fax:570-875-2281
Practice Address - Street 1:935 CENTRE ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:PA
Practice Address - Zip Code:17921-1243
Practice Address - Country:US
Practice Address - Phone:570-875-2271
Practice Address - Fax:570-875-2281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-21
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004303251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health