Healthcare Provider Details

I. General information

NPI: 1013405364
Provider Name (Legal Business Name): HEIDI FAITH UNTERBERG LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2018
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

745 MAIN ST STE 204
STROUDSBURG PA
18360
US

IV. Provider business mailing address

745 MAIN ST STE 204
STROUDSBURG PA
18360-2060
US

V. Phone/Fax

Practice location:
  • Phone: 570-994-2664
  • Fax: 570-694-6694
Mailing address:
  • Phone: 570-994-2664
  • Fax: 570-694-6694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC010211
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: