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General NPI Number Information
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NPI Number | 1700725280
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Entity Type | Organization
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Legal Business Name | MIND PRIME COUNSELING AND WELLNESS LLC
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Dates
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Enumeration Date | 03/27/2026
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Last Update Date | 03/27/2026
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Provider Practice Location Address
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Address Line | 4641 POTTSVILLE PIKE STE 101B
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City | READING
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State | PA
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Zip | 19605-9707
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Country | US
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Telephone | 484-451-8950
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Fax |
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Provider Business Mailing Address
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Address Line | 118 COLONIAL DR APT F
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City | READING
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State | PA
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Zip | 19607-3609
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Country | US
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Telephone | 717-829-7127
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | MRS. MCQUERNA NOLASCO-LOPEZ
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Credential | LPC
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Telephone | 717-829-7127
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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