Provider Demographics
NPI:1205572781
Name:FIRST CONCERNS COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:FIRST CONCERNS COUNSELING SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER / EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:PORAY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:570-301-3565
Mailing Address - Street 1:190 S RIVER ST STE A
Mailing Address - Street 2:
Mailing Address - City:PLAINS
Mailing Address - State:PA
Mailing Address - Zip Code:18705-1149
Mailing Address - Country:US
Mailing Address - Phone:570-301-3565
Mailing Address - Fax:
Practice Address - Street 1:190 S RIVER ST STE A
Practice Address - Street 2:
Practice Address - City:PLAINS
Practice Address - State:PA
Practice Address - Zip Code:18705-1149
Practice Address - Country:US
Practice Address - Phone:570-301-3565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-09
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PACW008651LOtherDEPARTMENT OF STATE - BUREAU OF PROFESSIONAL AND OCCUPATIONAL AFFAIRS
PA1252OtherPENNSYLVANIA CERTIFICATION BOARD