Healthcare Provider Details

I. General information

NPI: 1104212356
Provider Name (Legal Business Name): CARAMENICO COUNSELING GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2015
Last Update Date: 04/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W STATE ST SUITE 303
DOYLESTOWN PA
18901-2250
US

IV. Provider business mailing address

22 BERKELEY CT
DOYLESTOWN PA
18901-2643
US

V. Phone/Fax

Practice location:
  • Phone: 267-454-5322
  • Fax:
Mailing address:
  • Phone: 267-454-5322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC004773
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW017082
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMF000624
License Number StatePA

VIII. Authorized Official

Name: MRS. JENNIFER ERB CARAMENICO
Title or Position: SOLE PROPRIETOR/CLINICAL THERAPIST
Credential: LPC
Phone: 267-454-5322