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General NPI Number Information
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NPI Number | 1205794138
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Entity Type | Organization
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Legal Business Name | SOARING MANTIS COUNSELING LLC
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Dates
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Enumeration Date | 01/10/2026
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Last Update Date | 01/10/2026
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Provider Practice Location Address
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Address Line | 122 W LANCASTER AVE STE 205
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City | READING
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State | PA
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Zip | 19607-1874
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Country | US
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Telephone | 484-509-1413
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Fax |
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Provider Business Mailing Address
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Address Line | 45 WESLEYAN DR
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City | READING
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State | PA
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Zip | 19607-2211
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Country | US
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Telephone | 717-669-7349
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | AMBER DOMINIK
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Credential | LPC
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Telephone | 717-669-7349
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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