MEDICARE: SPACE BETWEEN THE WORDS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1033000641
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPACE BETWEEN THE WORDS LLC

Provider Business Mailing Address
First Line	:	1442 RAINER RD
Second Line	:
City	:	BROOKHAVEN
State	:	PA
Zip	:	19015-1940
Country	:	US
Telephone Number	:	484-441-3379
Fax Number	:

Provider Business Practice Location Address
First Line	:	1442 RAINER RD
Second Line	:
City	:	BROOKHAVEN
State	:	PA
Zip	:	19015-1940
Country	:	US
Telephone Number	:	484-441-3379
Fax Number	:

Authorized Official
Title or Position	:	OWNER / LICENSED PROFESSIONAL COUNS
Name	:	MR. MICHAEL EDWARD DRAG
Credential	:	LPC
Telephone Number	:	484-441-3379

Provider Enumeration Date	:	07/11/2025
Last Update Date	:	07/11/2025

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Directions to “SPACE BETWEEN THE WORDS LLC ” Practice Location

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