Healthcare Provider Details

I. General information

NPI: 1285252122
Provider Name (Legal Business Name): THE PLEASURE COLLECTIVE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2020
Last Update Date: 07/07/2020
Certification Date: 07/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 E JEFFERSON ST APT A7
MEDIA PA
19063-3847
US

IV. Provider business mailing address

313 E JEFFERSON ST APT A7
MEDIA PA
19063-3847
US

V. Phone/Fax

Practice location:
  • Phone: 445-544-3082
  • Fax:
Mailing address:
  • Phone: 445-544-3082
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MALIKA O'NEILL
Title or Position: OWNER
Credential: LPC
Phone: 445-544-3082