Healthcare Provider Details

I. General information

NPI: 1164664645
Provider Name (Legal Business Name): LISA M WELSH M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2009
Last Update Date: 11/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2370 YORK ROAD D-4
JAMISON PA
18929-2228
US

IV. Provider business mailing address

2370 YORK ROAD D-4
JAMISON PA
18929
US

V. Phone/Fax

Practice location:
  • Phone: 215-491-9900
  • Fax: 215-990-9902
Mailing address:
  • Phone: 215-491-9900
  • Fax: 215-990-9902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: