Provider Demographics
NPI:1356873806
Name:RECOVERY SOLUTIONS COUNSELING SERVICES
Entity type:Organization
Organization Name:RECOVERY SOLUTIONS COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, NCC, CRC, CAADC
Authorized Official - Phone:814-807-2746
Mailing Address - Street 1:PO BOX 347
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-0347
Mailing Address - Country:US
Mailing Address - Phone:814-807-2746
Mailing Address - Fax:888-965-3990
Practice Address - Street 1:262 CHESTNUT ST STE 1
Practice Address - Street 2:SUITE 1
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-3302
Practice Address - Country:US
Practice Address - Phone:814-807-2746
Practice Address - Fax:888-965-3990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-03
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007192101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103081417001Medicaid