| Centre Counseling And Wellness, Llc | |
|
315 S Allen St Suite 326 State College PA 16801-4849 | |
| (814) 387-8823 | |
| Not Available |
| Full Name | Centre Counseling And Wellness, Llc |
|---|---|
| Speciality | Counselor |
| Location | 315 S Allen St, State College, Pennsylvania |
| Authorized Official Name and Position | Jonathan Edwin Stube (OWNER) |
| Authorized Official Contact | 8143878823 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Centre Counseling And Wellness, Llc 315 S Allen St Suite 326 State College PA 16801-4849 Ph: (814) 387-8823 | Centre Counseling And Wellness, Llc 315 S Allen St Suite 326 State College PA 16801-4849 Ph: (814) 387-8823 |
| NPI Number | 1033650932 |
|---|---|
| Provider Enumeration Date | 03/13/2017 |
| Last Update Date | 03/13/2017 |
| Medicare PECOS PAC ID | 8527413400 |
|---|---|
| Medicare Enrollment ID | O20231012001849 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033650932 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | PC008236 (Pennsylvania) | Primary |
| Provider Name | Kelly Corinne Berthold |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376078089 PECOS PAC ID: 6800225343 Enrollment ID: I20200403000210 |
| Provider Name | Heather Stube |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679276919 PECOS PAC ID: 1052768124 Enrollment ID: I20231110001287 |
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