Healthcare Provider Details
I. General information
NPI: 1669578290
Provider Name (Legal Business Name): AFFINITY COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/14/2006
Last Update Date: 09/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2917 WINDMILL RD STE 4
SINKING SPRING PA
19608-1679
US
IV. Provider business mailing address
2917 WINDMILL RD STE 4
SINKING SPRING PA
19608-1679
US
V. Phone/Fax
- Phone: 610-670-7010
- Fax: 610-670-7910
- Phone: 610-670-7010
- Fax: 610-670-7910
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHELE
A
ROLAND
Title or Position: PARTNER
Credential: MA LPC
Phone: 610-670-7010