Healthcare Provider Details
I. General information
NPI: 1538949110
Provider Name (Legal Business Name): IRONWOOD COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/02/2023
Last Update Date: 10/02/2023
Certification Date: 10/02/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1534 W BROAD ST STE 600
QUAKERTOWN PA
18951-1050
US
IV. Provider business mailing address
701 W MACADA RD
BETHLEHEM PA
18017-2420
US
V. Phone/Fax
- Phone: 610-730-4755
- Fax:
- Phone: 610-730-4755
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: DR.
JENNIFER
CRALL
Title or Position: LICENSED PSYCHOLOGIST
Credential: PHD
Phone: 610-730-4755