Dr Mark William Deitrick, LPC | |
229 Portersville Rd, Ellwood City, PA 16117-2431 | |
(724) 752-9114 | |
(724) 657-3326 |
Full Name | Dr Mark William Deitrick |
---|---|
Gender | Male |
Speciality | Counselor - Professional |
Location | 229 Portersville Rd, Ellwood City, Pennsylvania |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1174755078 | NPI | - | NPPES |
251830792 | Other | PA | INTERGROUP SERVICES CORPORATION |
2114493 | Other | PA | HIGHMARK BLUE CROSS BLUE SHEILD |
12765444 | Other | MULTIPLAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | PC000115 (Pennsylvania) | Primary |
Entity Name | Cornerstone Wellness Center Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1316513344 PECOS PAC ID: 4789076761 Enrollment ID: O20220125001944 |
Mailing Address | Practice Location Address |
---|---|
Dr Mark William Deitrick, LPC 2703 W State St, New Castle, PA 16101-8671 Ph: (724) 657-3303 | Dr Mark William Deitrick, LPC 229 Portersville Rd, Ellwood City, PA 16117-2431 Ph: (724) 752-9114 |
Mary Skalski, LPC, NCC RETIRED, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 505 Jefferson Ave, Ellwood City, PA 16117 Phone: 724-630-1100 | |
Emerson David Kurjakovic, MS, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1099 Davis Rd, Ellwood City, PA 16117 Phone: 724-602-2224 Fax: 724-218-3958 | |
Marisa Fusetti, Counselor Medicare: Not Enrolled in Medicare Practice Location: 773 Pershing St, Ellwood City, PA 16117 Phone: 412-221-1091 | |
Kala Cunningham, MA, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 523 Deemer Ave, Ellwood City, PA 16117 Phone: 724-674-8751 | |
Emily Kay Romeo, NCC, LPC Counselor Medicare: Medicare Enrolled Practice Location: 226 5th St, Ellwood City, PA 16117 Phone: 724-630-1561 | |
Jessica Weller, Counselor Medicare: Not Enrolled in Medicare Practice Location: 403 Orchard Ave, Ellwood City, PA 16117 Phone: 724-674-6306 |