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General NPI Number Information
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NPI Number | 1235625716
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Entity Type | Organization
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Legal Business Name | BEYOND COUNSELING CENTER, LLC
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Dates
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Enumeration Date | 07/08/2018
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Last Update Date | 04/29/2019
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Provider Practice Location Address
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Address Line | 16 SHERWOOD DRIVE SUITE C
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City | BLOOMSBURG
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State | PA
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Zip | 17815-3086
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Country | US
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Telephone | 570-204-4028
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Fax | 570-445-2214
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Provider Business Mailing Address
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Address Line | 16 SHERWOOD DRIVE SUITE C
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City | BLOOMSBURG
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State | PA
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Zip | 17815-3086
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Country | US
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Telephone | 570-204-4028
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Fax | 570-445-2214
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | MRS. PAMELA ROSE COSPER
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Credential | LCSW
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Telephone | 570-204-4028
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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 | CW018964
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License Number State | PA
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