MEDICARE: REFRESH 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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1750904082
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REFRESH COUNSELING SERVICES, LLC

Provider Business Mailing Address
First Line	:	305 SHADELAND AVE
Second Line	:
City	:	DREXEL HILL
State	:	PA
Zip	:	19026-2226
Country	:	US
Telephone Number	:	610-888-0137
Fax Number	:	215-877-5181

Provider Business Practice Location Address
First Line	:	1319 N 52ND ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19131-4412
Country	:	US
Telephone Number	:	610-888-0137
Fax Number	:

Authorized Official
Title or Position	:	CEO/PSYCHOTHERAPIST
Name	:	DR. MELISSA JONES
Credential	:	LPC
Telephone Number	:	610-888-0137

Provider Enumeration Date	:	05/21/2020
Last Update Date	:	05/21/2020

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