Healthcare Provider Details

I. General information

NPI: 1518540541
Provider Name (Legal Business Name): MEW COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2021
Last Update Date: 04/28/2021
Certification Date: 04/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1810 PITTSTON AVE REAR
SCRANTON PA
18505-4506
US

IV. Provider business mailing address

1810 PITTSTON AVE REAR
SCRANTON PA
18505-4506
US

V. Phone/Fax

Practice location:
  • Phone: 272-800-8295
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MR. MARK EDWARD WERGER
Title or Position: OUTPATIENT THERAPIST
Credential: LCSW
Phone: 272-800-8295