Healthcare Provider Details

I. General information

NPI: 1245267129
Provider Name (Legal Business Name): INNOVATIVE COUNSELING ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 CREEKSIDE DR SUITE 601
POTTSTOWN PA
19464-9204
US

IV. Provider business mailing address

600 CREEKSIDE DR STE 601
POTTSTOWN PA
19464-9204
US

V. Phone/Fax

Practice location:
  • Phone: 610-326-2728
  • Fax: 610-326-2750
Mailing address:
  • Phone: 610-326-2728
  • Fax: 610-326-2750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: DEBRA L. FETTERMAN
Title or Position: BUSINESS OWNER
Credential:
Phone: 610-326-2728