Provider Demographics
NPI:1649928375
Name:ARCHER, ALYSSA (NCC, MA)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:ARCHER
Suffix:
Gender:F
Credentials:NCC, MA
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:J
Other - Last Name:ARCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:54 MARION DR
Mailing Address - Street 2:
Mailing Address - City:ZELIENOPLE
Mailing Address - State:PA
Mailing Address - Zip Code:16063-9705
Mailing Address - Country:US
Mailing Address - Phone:724-234-7369
Mailing Address - Fax:
Practice Address - Street 1:30 GLADE RUN DR
Practice Address - Street 2:
Practice Address - City:ZELIENOPLE
Practice Address - State:PA
Practice Address - Zip Code:16063-2200
Practice Address - Country:US
Practice Address - Phone:724-234-7369
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-11
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health