Provider Demographics
NPI:1538629381
Name:MILLCREEK COUNSELING & MENTAL HEALTH ADVOCACY PARTNERSHIP CORP
Entity type:Organization
Organization Name:MILLCREEK COUNSELING & MENTAL HEALTH ADVOCACY PARTNERSHIP CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:C
Authorized Official - Last Name:BORLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-449-6477
Mailing Address - Street 1:1738 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-5024
Mailing Address - Country:US
Mailing Address - Phone:814-722-7467
Mailing Address - Fax:814-836-8194
Practice Address - Street 1:1738 W 8TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505-5024
Practice Address - Country:US
Practice Address - Phone:814-449-6477
Practice Address - Fax:814-836-8194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-20
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty