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General NPI Number Information
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NPI Number | 1417248444
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Entity Type | Organization
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Legal Business Name | INNERVISION COUNSELING, LLC
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Dates
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Enumeration Date | 04/25/2011
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Last Update Date | 04/25/2011
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Provider Practice Location Address
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Address Line | 3201 HIGHFIELD DR SUITE M
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City | BETHLEHEM
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State | PA
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Zip | 18020-1113
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Country | US
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Telephone | 484-896-0075
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Fax |
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Provider Business Mailing Address
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Address Line | 517 6TH ST
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City | WIND GAP
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State | PA
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Zip | 18091-1311
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARY WERTHEIMER
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Credential | LSW
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Telephone | 484-896-0075
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | SW125979
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License Number State | PA
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