Provider Demographics
NPI:1730220914
Name:KATHLEEN SHIREY MARITAL AND FAMILY COUNSELING, INC.
Entity type:Organization
Organization Name:KATHLEEN SHIREY MARITAL AND FAMILY COUNSELING, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:LORI
Authorized Official - Last Name:SHIREY
Authorized Official - Suffix:
Authorized Official - Credentials:MED, LMFT
Authorized Official - Phone:724-832-1900
Mailing Address - Street 1:1225 S MAIN ST
Mailing Address - Street 2:SUITE 201B
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-5370
Mailing Address - Country:US
Mailing Address - Phone:724-832-1900
Mailing Address - Fax:724-853-6704
Practice Address - Street 1:1225 S MAIN ST
Practice Address - Street 2:SUITE 201B
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-5370
Practice Address - Country:US
Practice Address - Phone:724-832-1900
Practice Address - Fax:724-853-6704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000197305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA464458OtherVBH AND VALUEOPTIONS