1497837355 NPI number — IVYLAND COUNSELING CENTER, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497837355 NPI number — IVYLAND COUNSELING CENTER, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
IVYLAND COUNSELING CENTER, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497837355
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1210 OLD YORK RD
Provider Second Line Business Mailing Address:
STE 202
Provider Business Mailing Address City Name:
WARMINSTER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18974-2013
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-444-9204
Provider Business Mailing Address Fax Number:
215-444-9206

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1210 OLD YORK RD
Provider Second Line Business Practice Location Address:
STE 202
Provider Business Practice Location Address City Name:
WARMINSTER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18974-2013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-444-9204
Provider Business Practice Location Address Fax Number:
215-444-9206
Provider Enumeration Date:
10/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HEINRICHS
Authorized Official First Name:
GLENN
Authorized Official Middle Name:
ALLEN
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
215-444-9204

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  PS015521 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com