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General NPI Number Information
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NPI Number | 1578446217
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Entity Type | Organization
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Legal Business Name | MEGHAN WALLACE COUNSELING SERVICES
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Dates
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Enumeration Date | 07/29/2025
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 255 S 17TH ST STE 1504
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City | PHILADELPHIA
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State | PA
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Zip | 19103-6215
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Country | US
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Telephone | 215-362-3040
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Fax |
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Provider Business Mailing Address
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Address Line | 413 WALLACE ST UNIT 2D
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City | PHILADELPHIA
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State | PA
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Zip | 19123-2297
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Country | US
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Telephone | 267-644-5258
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MEGHAN WALLACE
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Credential | LPC
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Telephone | 215-362-3040
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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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