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General NPI Number Information
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NPI Number | 1558178541
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Entity Type | Organization
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Legal Business Name | RECOVER PSYCHOTHERAPY & COUNSELING SERVICESLLC
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Dates
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Enumeration Date | 12/13/2024
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Last Update Date | 12/13/2024
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Provider Practice Location Address
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Address Line | 1005 BROOKSIDE RD STE 80
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City | ALLENTOWN
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State | PA
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Zip | 18106-9023
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Country | US
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Telephone | 484-867-7078
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Fax | 833-381-0909
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Provider Business Mailing Address
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Address Line | 4403 BIRKLAND PL # 1010
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City | EASTON
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State | PA
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Zip | 18045-4701
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Country | US
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Telephone | 484-867-7078
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Fax | 833-381-0909
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Authorized Official
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Title or Position | OWNER
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Name | AMY RUDISILL
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Credential | LPC
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Telephone | 484-867-7078
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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 |
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License Number State |
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Taxonomy #2
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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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