Provider Demographics
NPI:1295463511
Name:BALUH, KELLY ANN (LPC)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:ANN
Last Name:BALUH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1632 E LAUREL CIR
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:PA
Mailing Address - Zip Code:15666-2180
Mailing Address - Country:US
Mailing Address - Phone:724-875-5425
Mailing Address - Fax:
Practice Address - Street 1:1 NORTHGATE SQ
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-1341
Practice Address - Country:US
Practice Address - Phone:724-689-6118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-14
Last Update Date:2022-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC011321101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty