Healthcare Provider Details

I. General information

NPI: 1780832329
Provider Name (Legal Business Name): LIHN CENTER FOR PSYCHOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2008
Last Update Date: 09/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1216 DARBY RD
HAVERTOWN PA
19083-3603
US

IV. Provider business mailing address

1216 DARBY RD
HAVERTOWN PA
19083-3603
US

V. Phone/Fax

Practice location:
  • Phone: 610-446-9669
  • Fax: 610-446-4912
Mailing address:
  • Phone: 610-446-9669
  • Fax: 610-446-4912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC000665
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS006366L
License Number StatePA

VIII. Authorized Official

Name: DR. JOANN COHEN
Title or Position: DIRECTOR
Credential: PHD
Phone: 610-446-9669