Healthcare Provider Details

I. General information

NPI: 1346706769
Provider Name (Legal Business Name): A. L. COLLEY & ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2019
Last Update Date: 03/22/2023
Certification Date: 03/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 WASHINGTON LN STE 6A2
WYNCOTE PA
19095-1426
US

IV. Provider business mailing address

25 WASHINGTON LN STE 6A2
WYNCOTE PA
19095-1426
US

V. Phone/Fax

Practice location:
  • Phone: 267-800-6589
  • Fax: 773-632-0572
Mailing address:
  • Phone: 267-800-6589
  • Fax: 773-632-0572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierAR15231
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerPHILADELPHIA INSURANCE COMPANY

VIII. Authorized Official

Name: ANN COLLEY
Title or Position: OWNER
Credential:
Phone: 267-235-4546