Provider Demographics
NPI:1871084988
Name:PUGH, ALVA ALTHEA (LPC)
Entity type:Individual
Prefix:MRS
First Name:ALVA
Middle Name:ALTHEA
Last Name:PUGH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1104 FIELDSTONE CIR NE
Mailing Address - Street 2:
Mailing Address - City:BOLIVAR
Mailing Address - State:OH
Mailing Address - Zip Code:44612-8666
Mailing Address - Country:US
Mailing Address - Phone:330-224-0571
Mailing Address - Fax:
Practice Address - Street 1:1433 5TH ST NW
Practice Address - Street 2:
Practice Address - City:NEW PHILADELPHIA
Practice Address - State:OH
Practice Address - Zip Code:44663
Practice Address - Country:US
Practice Address - Phone:330-343-8171
Practice Address - Fax:330-260-5298
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-24
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1200542101YM0800X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor