Healthcare Provider Details

I. General information

NPI: 1023755915
Provider Name (Legal Business Name): ABIDE CHRISTIAN COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2022
Last Update Date: 05/12/2022
Certification Date: 05/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 GRAVEL HILL RD
MOUNT WOLF PA
17347-9710
US

IV. Provider business mailing address

140 GRAVEL HILL RD
MOUNT WOLF PA
17347-9710
US

V. Phone/Fax

Practice location:
  • Phone: 607-372-7102
  • Fax:
Mailing address:
  • Phone: 607-372-7102
  • 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 Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE VARANO
Title or Position: THERAPIST
Credential: LMFT
Phone: 607-372-7102