Healthcare Provider Details

I. General information

NPI: 1891034641
Provider Name (Legal Business Name): CELESTE H HUTCHINSON MA, LPC, CCDP-D, ETC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2013
Last Update Date: 07/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 CHESTNUT ST STE 404
PHILADELPHIA PA
19106
US

IV. Provider business mailing address

128 CHESTNUT ST STE 404
PHILADELPHIA PA
19106-3024
US

V. Phone/Fax

Practice location:
  • Phone: 215-544-3241
  • Fax:
Mailing address:
  • Phone: 215-544-3241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC005274
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: