Provider Demographics
NPI:1366152894
Name:GULVAS, LAURESA ANN (LPC)
Entity type:Individual
Prefix:
First Name:LAURESA
Middle Name:ANN
Last Name:GULVAS
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 1:101 COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:EMLENTON
Mailing Address - State:PA
Mailing Address - Zip Code:16373-9711
Mailing Address - Country:US
Mailing Address - Phone:814-590-3394
Mailing Address - Fax:
Practice Address - Street 1:240 ALLEGHENY BLVD STE H
Practice Address - Street 2:
Practice Address - City:BROOKVILLE
Practice Address - State:PA
Practice Address - Zip Code:15825-2326
Practice Address - Country:US
Practice Address - Phone:814-849-2488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-23
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC015110101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional