Provider Demographics
NPI:1760469365
Name:HLAVSA, DARYL (MS, ATR-BC, LPC)
Entity type:Individual
Prefix:MS
First Name:DARYL
Middle Name:
Last Name:HLAVSA
Suffix:
Gender:F
Credentials:MS, ATR-BC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 HARTMAN ROAD BOX 12
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-6920
Mailing Address - Country:US
Mailing Address - Phone:724-972-1242
Mailing Address - Fax:724-238-1828
Practice Address - Street 1:125 HARTMAN ROAD BOX 12
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-6920
Practice Address - Country:US
Practice Address - Phone:724-972-1242
Practice Address - Fax:724-238-1828
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-27
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC001532101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1001348580007Medicaid