person
Mrs. Jacqueline Judeth Costello-atherton-ely, LPC
Professional Counselor in Old Forge, Pennsylvania
NPI 1568547313

Jacqueline Judeth Costello-atherton-ely is a Professional Counselor based in Old Forge, PA and is specialized in Professional. Jacqueline Judeth Costello-atherton-ely practices in Old Forge, PA and has the professional credentials of LPC. The NPI Number for Jacqueline Judeth Costello-atherton-ely is 1568547313 and holds a License No. PC002586 (Pennsylvania).

The current practice location address for Jacqueline Judeth Costello-atherton-ely is 516 Moosic Rd, Old Forge, PA and can be reached out via phone at 570-562-1166 and via fax at 570-457-3779.

Location: 516 Moosic Rd, Old Forge, PA, 18518-2027
person
Provider Profile Details
NPI Number
1568547313
Provider Name
Jacqueline Judeth Costello-atherton-ely
Credential
LPC
Provider Entity Type
Individual
Gender
Female
Address
516 Moosic Rd, Old Forge, PA, 18518-2027
Phone Number
570-562-1166
Fax Number
570-457-3779
Provider Enumeration Date
10/26/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0015080380002 05 PA
institution
Provider Business Practice Location Address Details
Address
516 Moosic Rd
City
State
Zip
18518-2027
Phone Number
570-562-1166
Fax Number
570-457-3779
person
Provider Business Mailing Address Details
Address
516 Moosic Rd
City
State
Zip
18518-2027
Phone Number
570-562-1166
Fax Number
570-457-3779
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
PC002586 (Pennsylvania)
Definition
Definition to come...
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