is a Counselor in Media, Pennsylvania. practices all healthcare services and medical treatments related to Counselor. The NPI Number for is 1851441190. The last update date is .
's current location address is 211 West State Street, Media, Pennsylvania. You can contact this provider via phone number 8562564260. The mailing address for is 211 West State Street, Media, Pennsylvania. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 211 West State Street, Media, Pennsylvania |
| Phone Number | 8562564260 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1851441190 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 211 West State Street |
|---|---|
| City | Media |
| State | Pennsylvania (PA) |
| Post Code | 19063 |
| Phone Number | 8562564260 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Counselor |
|---|---|
| Taxonomy | 101Y00000X |
| Licence No | PC000589 |
|
Definition: A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supe |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 11491672 | PA | CAQH |
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