Organization
WATERSHED COUNSELING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA FRANK LPC, NCC, CAADC (OWNER/DIRECTOR)
(814) 347-5018
Entity
Organization
Contact information
Practice address
143 W. MAIN ST., SUITE 110, NORTH EAST, PA 16428-1333
(814) 347-5018
(814) 347-5186
Mailing address
143 WEST MAIN STREET, SUITE 110, NORTH EAST, PA 16428-1333
(814) 347-5018
(814) 347-5186
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
PC010131
PA
261QM0850X
Adult Mental Health Clinic/Center
PC010131
PA
261QM0855X
Adolescent and Children Mental Health Clinic/Center
PC010131
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1035120880001
—
PA
01
—
12348
CERTIFIED ADVANCED ALCOHOL & DRUG COUNSELOR
PA
01
—
319006
NATIONAL CERTIFIED COUNSELOR
—
01
—
PC010131
LICENSED PROFESSIONAL COUNSELOR
PA
Enumeration date
01/16/2018
Last updated
11/04/2024
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