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General NPI Number Information
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NPI Number | 1144524638
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Entity Type | Organization
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Legal Business Name | VITA COUNSELING PARTNERS
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Dates
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Enumeration Date | 12/27/2010
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Last Update Date | 12/20/2018
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Provider Practice Location Address
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Address Line | 3295 FOREST INN RD STE 3
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City | PALMERTON
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State | PA
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Zip | 18071-5467
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Country | US
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Telephone | 610-826-8482
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Fax | 610-826-8483
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Provider Business Mailing Address
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Address Line | 3295 FOREST INN RD STE 3
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City | PALMERTON
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State | PA
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Zip | 18071-5467
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Country | US
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Telephone | 610-826-8482
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Fax | 610-826-8483
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | PAMELA TIBBS
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Credential | LCSW
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Telephone | 855-826-8482
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW015916
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License Number State | PA
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