Provider Demographics
NPI:1235187196
Name:MASSELLA, JOHN D (EDD, LPC, NCC, CCS,)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:D
Last Name:MASSELLA
Suffix:
Gender:M
Credentials:EDD, LPC, NCC, CCS,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 CASTLEBROOKE DR
Mailing Address - Street 2:
Mailing Address - City:VENETIA
Mailing Address - State:PA
Mailing Address - Zip Code:15367-1391
Mailing Address - Country:US
Mailing Address - Phone:724-942-5422
Mailing Address - Fax:
Practice Address - Street 1:4160 WASHINGTON RD
Practice Address - Street 2:SUITE 201
Practice Address - City:MC MURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-2533
Practice Address - Country:US
Practice Address - Phone:412-608-3861
Practice Address - Fax:724-938-1569
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC000193101Y00000X, 101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health