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General NPI Number Information
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NPI Number | 1235527177
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Entity Type | Organization
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Legal Business Name | JPA CENTER FOR INTEGRATIVE HEALTH, LLC
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Dates
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Enumeration Date | 12/30/2014
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Last Update Date | 12/30/2014
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Provider Practice Location Address
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Address Line | 601 SUMMIT AVE
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City | JENKINTOWN
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State | PA
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Zip | 19046-3238
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Country | US
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Telephone | 215-885-1252
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Fax |
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Provider Business Mailing Address
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Address Line | 601 SUMMIT AVE
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City | JENKINTOWN
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State | PA
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Zip | 19046-3238
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Country | US
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Telephone | 215-885-1252
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | MRS. TERESA ANN MONTANARO
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Credential | M.ED., BCBA
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Telephone | 215-885-1252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PS016264
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW016239
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License Number State | PA
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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 | CW016689
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-09-5329
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License Number State | PA
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