Healthcare Provider Details

I. General information

NPI: 1437879582
Provider Name (Legal Business Name): JUNIPER COUNSELING AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2022
Last Update Date: 08/30/2022
Certification Date: 08/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 BROWNSVILLE RD
ROMANSVILLE PA
19320-4784
US

IV. Provider business mailing address

1321 BROWNSVILLE RD
ROMANSVILLE PA
19320-4784
US

V. Phone/Fax

Practice location:
  • Phone: 484-718-2143
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW SNYDER
Title or Position: CLINICAL DIRECTOR
Credential: LPC, PH.D
Phone: 484-718-2143