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General NPI Number Information
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NPI Number | 1366911836
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Entity Type | Organization
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Legal Business Name | NEUROFEEDBACK AND COUNSELING CENTER OF PA
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Dates
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Enumeration Date | 11/14/2018
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Last Update Date | 09/14/2023
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Provider Practice Location Address
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Address Line | 3109 N FRONT ST
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City | HARRISBURG
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State | PA
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Zip | 17110-1310
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Country | US
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Telephone | 717-202-2510
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Fax | 717-412-0823
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Provider Business Mailing Address
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Address Line | 3109 N FRONT ST
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City | HARRISBURG
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State | PA
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Zip | 17110-1310
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Country | US
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Telephone | 717-202-2510
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Fax | 717-412-0823
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Authorized Official
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Title or Position | OWNER
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Name | AMANDA LEVISON
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Credential | MS, LMHC, LPC
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Telephone | 717-202-2510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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