Healthcare Provider Details
I. General information
NPI: 1043937097
Provider Name (Legal Business Name): MILESTONE COUNSELING & WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/20/2022
Last Update Date: 10/24/2022
Certification Date: 10/24/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
301 OXFORD VALLEY RD STE 304B
YARDLEY PA
19067-7709
US
IV. Provider business mailing address
301 OXFORD VALLEY RD STE 304B
YARDLEY PA
19067-7709
US
V. Phone/Fax
- Phone: 215-603-8409
- Fax:
- Phone: 215-603-8409
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
ERIC
MARSEGLIA
Title or Position: OWNER
Credential: J.D.
Phone: 215-603-8409