Healthcare Provider Details
I. General information
NPI: 1104747658
Provider Name (Legal Business Name): UNIVERSAL MIND THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3477 CORPORATE PKWY STE 100
CENTER VALLEY PA
18034-8237
US
IV. Provider business mailing address
3477 CORPORATE PKWY STE 100
CENTER VALLEY PA
18034-8237
US
V. Phone/Fax
- Phone: 484-523-3886
- Fax: 610-862-3716
- Phone: 484-523-3886
- Fax: 610-862-3716
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LIZA
JOAN
ALVARADO
Title or Position: OWNER/PSYCHOTHERAPIST
Credential: LPC
Phone: 484-523-3886