Healthcare Provider Details

I. General information

NPI: 1881620250
Provider Name (Legal Business Name): BERKS COUNSELING CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 02/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 PENN STREET 2ND FLOOR
READING PA
19601
US

IV. Provider business mailing address

645 PENN STREET 2ND FLOOR
READING PA
19601
US

V. Phone/Fax

Practice location:
  • Phone: 610-373-4281
  • Fax: 610-373-3779
Mailing address:
  • Phone: 610-373-4281
  • Fax: 610-373-3779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number067063
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number206900
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number223690
License Number StatePA

VIII. Authorized Official

Name: MRS. CHRISTINE MARY AXFORD
Title or Position: DEPUTY DIRECTOR
Credential:
Phone: 610-373-4281