MEDICARE: AFFINITY COUNSELING SERVICES 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	101YM0800X	Mental Health Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	50020228	OTHER	PA	CAPITAL BLUE CROSS
2	7890663	OTHER	PA	AETNA
3	2400265000	OTHER	PA	INDEP BC PERSONAL CHOICE

General Provider Information

NPI Number	:	1669578290
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AFFINITY COUNSELING SERVICES LLC

Provider Business Mailing Address
First Line	:	2917 WINDMILL RD
Second Line	:	STE 4
City	:	SINKING SPRING
State	:	PA
Zip	:	19608-1679
Country	:	US
Telephone Number	:	610-670-7010
Fax Number	:	610-670-7910

Provider Business Practice Location Address
First Line	:	2917 WINDMILL RD
Second Line	:	STE 4
City	:	SINKING SPRING
State	:	PA
Zip	:	19608-1679
Country	:	US
Telephone Number	:	610-670-7010
Fax Number	:	610-670-7910

Authorized Official
Title or Position	:	PARTNER
Name	:	MICHELE A ROLAND
Credential	:	MA LPC
Telephone Number	:	610-670-7010

Provider Enumeration Date	:	09/14/2006
Last Update Date	:	09/04/2012

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Directions to “AFFINITY COUNSELING SERVICES LLC ” Practice Location

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