MEDICARE: NEST COUNESLING 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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1578395729
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEST COUNESLING LLC

Provider Business Mailing Address
First Line	:	104 VALLEY VIEW RD
Second Line	:
City	:	MEDIA
State	:	PA
Zip	:	19063-1431
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	110A BALTIMORE PIKE # 1057
Second Line	:
City	:	SPRINGFIELD
State	:	PA
Zip	:	19064-3629
Country	:	US
Telephone Number	:	484-904-2753
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MEGAN ELLOW
Credential	:
Telephone Number	:	484-904-2753

Provider Enumeration Date	:	08/16/2024
Last Update Date	:	08/16/2024

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