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General NPI Number Information
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NPI Number | 1366309528
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Entity Type | Organization
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Legal Business Name | COURAGEOUS RESILIENCE THERAPY
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Dates
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Enumeration Date | 01/08/2026
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 1518 WALNUT ST STE 1414
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City | PHILADELPHIA
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State | PA
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Zip | 19102-3408
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Country | US
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Telephone | 215-983-7213
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Fax |
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Provider Business Mailing Address
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Address Line | 7949 RIDGE AVE APT B6
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City | PHILADELPHIA
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State | PA
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Zip | 19128-3014
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Country | US
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Telephone | 215-983-7213
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Fax |
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Authorized Official
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Title or Position | LICENSED THERAPIST
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Name | CARLY DEE GEIS
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Credential | MDIV, MS, LPC
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Telephone | 901-499-6823
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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