MEDICARE: RESILIENCY & HOPE THERAPEUTIC COUNSELING, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1245972876
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESILIENCY & HOPE THERAPEUTIC COUNSELING, LLC

Provider Business Mailing Address
First Line	:	PO BOX 54743
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19148-0743
Country	:	US
Telephone Number	:	267-314-7814
Fax Number	:

Provider Business Practice Location Address
First Line	:	1047 TREE ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19148-3012
Country	:	US
Telephone Number	:	267-314-7814
Fax Number	:

Authorized Official
Title or Position	:	COUNSELOR
Name	:	PAULA L WERNER
Credential	:	LPC
Telephone Number	:	267-314-0234

Provider Enumeration Date	:	04/13/2022
Last Update Date	:	04/20/2022

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