=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558237727
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MOVE AND DANCEOLOGY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/15/2025
-----------------------------------------------------
Last Update Date | 10/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4001 MAIN ST APT 204
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19127-2142
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 267-219-8429
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 721 KENMARE RD
-----------------------------------------------------
City | BALA CYNWYD
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19004-2109
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-809-5709
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SOLE MEMBER AND ORGANIZER
-----------------------------------------------------
Name | SARA EARL
-----------------------------------------------------
Credential | MS, LPC, NCC, BC-DMT
-----------------------------------------------------
Telephone | 512-809-5709
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0801X
-----------------------------------------------------
Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------