Organization
ST ANTHONYS POINT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH J MIKITA MA (PSYCHOLOGIST OWNER)
(724) 982-0414
Entity
Organization
Contact information
Practice address
3679 E STATE ST, HERMITAGE, PA 16148-3411
(724) 982-0414
(724) 982-4407
Mailing address
3679 E STATE ST, HERMITAGE, PA 16148-3411
(724) 982-0414
(724) 982-4407
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
PC006662
PA
103K00000X
Behavior Analyst
PC005176
—
103T00000X
Psychologist
Primary
—
—
103TB0200X
Cognitive & Behavioral Psychologist
PS008073L
PA
103TC1900X
Counseling Psychologist
PS008073L
PA
104100000X
Social Worker
SW128655
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001397685
HIGHMARK BCBS
PA
05
—
0018158430001
—
PA
Enumeration date
08/25/2006
Last updated
05/13/2013
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