Healthcare Provider Details

I. General information

NPI: 1477231462
Provider Name (Legal Business Name): BREATHE EASY THERAPY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2023
Last Update Date: 07/10/2023
Certification Date: 07/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3477 CORPORATE PARKWAY SUITE 100
CENTER VALLEY PA
18034
US

IV. Provider business mailing address

3477 CORPORATE PARKWAY SUITE 100
CENTER VALLEY PA
18034
US

V. Phone/Fax

Practice location:
  • Phone: 267-223-9212
  • Fax:
Mailing address:
  • Phone: 267-223-9212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CYNTHIA A PICCINI
Title or Position: OWNER
Credential: LMFT
Phone: 570-994-3240