Healthcare Provider Details

I. General information

NPI: 1508352253
Provider Name (Legal Business Name): NEIGHBORHOOD COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2018
Last Update Date: 07/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 S MAIN ST STE C
MANHEIM PA
17545-1685
US

IV. Provider business mailing address

112 S MAIN ST STE C
MANHEIM PA
17545-1685
US

V. Phone/Fax

Practice location:
  • Phone: 148-447-7822
  • Fax:
Mailing address:
  • Phone: 148-447-7822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License NumberPC009626
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License NumberPC009626
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License NumberPC009626
License Number StatePA

VII. Legacy identifiers

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

VIII. Authorized Official

Name: NICOLE MARIE PFAFF
Title or Position: OWNER
Credential: LPC, PHD
Phone: 484-477-8223