Provider Demographics
NPI:1871766907
Name:DICOLA, STACY LYNN (MS ED)
Entity type:Individual
Prefix:MS
First Name:STACY
Middle Name:LYNN
Last Name:DICOLA
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 NESBITT RD
Mailing Address - Street 2:SUITE #262
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105-3410
Mailing Address - Country:US
Mailing Address - Phone:724-866-7994
Mailing Address - Fax:
Practice Address - Street 1:26 NESBITT RD
Practice Address - Street 2:SUITE #262
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-3410
Practice Address - Country:US
Practice Address - Phone:724-866-7994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-09
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004787101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional