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General NPI Number Information
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NPI Number | 1174173504
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Entity Type | Organization
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Legal Business Name | VALLEY COUNSELING CENTER
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Dates
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Enumeration Date | 09/17/2019
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Last Update Date | 09/17/2019
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Provider Practice Location Address
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Address Line | 1215 MANOR DR STE 209
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City | MECHANICSBURG
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State | PA
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Zip | 17055-4936
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Country | US
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Telephone | 717-489-2303
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Fax |
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Provider Business Mailing Address
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Address Line | 1215 MANOR DR STE 209
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City | MECHANICSBURG
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State | PA
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Zip | 17055-4936
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CARINA WISE
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Credential | LMFT
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Telephone | 717-489-2303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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