Healthcare Provider Details

I. General information

NPI: 1578308557
Provider Name (Legal Business Name): TWARDOWSKI COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2024
Last Update Date: 07/01/2024
Certification Date: 06/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 DORRANCE STREET
WYOMING PA
18644
US

IV. Provider business mailing address

120 DORRANCE ST
WYOMING PA
18644-1914
US

V. Phone/Fax

Practice location:
  • Phone: 570-697-5129
  • Fax:
Mailing address:
  • Phone: 570-697-5129
  • 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: THOMAS MARK TWARDOWSKI
Title or Position: OWNER/PSYCHOTHERAPIST
Credential: LCSW
Phone: 484-597-0433