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General NPI Number Information
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NPI Number | 1932793627
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Entity Type | Organization
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Legal Business Name | BIRTHSTONE TRAUMA HEALING, LLC
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Dates
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Enumeration Date | 02/24/2021
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Last Update Date | 02/24/2021
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Provider Practice Location Address
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Address Line | 1500 WALNUT ST STE 603
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City | PHILADELPHIA
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State | PA
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Zip | 19102-3516
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Country | US
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Telephone | 215-258-8080
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Fax |
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Provider Business Mailing Address
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Address Line | 1943 N HOWARD ST
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City | PHILADELPHIA
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State | PA
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Zip | 19122-2411
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Country | US
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Telephone | 434-509-3397
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | TIMOTHY ANDREW SOSIN
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Credential | MA, LPC, NCC
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Telephone | 215-258-8080
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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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