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General NPI Number Information
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NPI Number | 1972832780
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Entity Type | Organization
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Legal Business Name | CATHOLIC CLINICAL CONSULTANTS
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Dates
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Enumeration Date | 12/08/2009
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Last Update Date | 11/09/2021
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Provider Practice Location Address
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Address Line | 100 LEVITTOWN PKWY
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City | LEVITTOWN
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State | PA
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Zip | 19054-3502
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Country | US
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Telephone | 267-337-4540
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Fax |
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Provider Business Mailing Address
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Address Line | 100 LEVITTOWN PKWY
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City | LEVITTOWN
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State | PA
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Zip | 19054-3502
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Country | US
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Telephone | 267-337-4540
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Fax |
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Authorized Official
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Title or Position | PROGRAM MANAGER
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Name | RACHEL MEADE
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Credential |
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Telephone | 267-337-4540
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PS007712-L
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License Number State | PA
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