Healthcare Provider Details

I. General information

NPI: 1184400665
Provider Name (Legal Business Name): ASSOCIATES IN NEUROPSYCHOLOGY & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2023
Last Update Date: 08/31/2023
Certification Date: 08/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 BERKSHIRE BLVD STE 201
WYOMISSING PA
19610-1221
US

IV. Provider business mailing address

1100 BERKSHIRE BLVD STE 201
WYOMISSING PA
19610-1221
US

V. Phone/Fax

Practice location:
  • Phone: 518-817-2680
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: JANINE YORK
Title or Position: LICENSED PSYCHOLOGIST/CO-OWNER
Credential: PSY.D.
Phone: 518-817-2680