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General NPI Number Information
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NPI Number | 1003328576
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Entity Type | Organization
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Legal Business Name | WISER COUNSELING, LLC
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Dates
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Enumeration Date | 10/24/2017
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Last Update Date | 06/19/2018
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Provider Practice Location Address
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Address Line | 505 S 22ND ST
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City | PHILADELPHIA
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State | PA
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Zip | 19146
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Country | US
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Telephone | 484-800-1747
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Fax |
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Provider Business Mailing Address
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Address Line | 2103 CARPENTER ST UNIT B
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City | PHILADELPHIA
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State | PA
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Zip | 19146-2515
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Country | US
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Telephone | 609-602-4075
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Fax |
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Authorized Official
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Title or Position | OWNER, LPC
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Name | MS. REBECCA GOLDSTEIN
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Credential | MA, LPC
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Telephone | 609-602-4075
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | PC008053
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License Number State | PA
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