Organization
FAMILY THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLENE GIBSON LCSW (CEO)
(814) 254-4351
Entity
Organization
Contact information
Practice address
307 MARKET ST, JOHNSTOWN, PA 15901-1701
(814) 254-4351
Mailing address
PO BOX 273, JOHNSTOWN, PA 15907-0273
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
0904009477
VA
1041C0700X
Clinical Social Worker
Primary
CW018684
PA
Other
Enumeration date
12/09/2016
Last updated
12/09/2016
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