MEDICARE: WELL-BEING CENTER

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	PC005919	PA

General Provider Information

NPI Number	:	1861861320
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELL-BEING CENTER

Provider Business Mailing Address
First Line	:	63 W LANCASTER AVE
Second Line	:	SUITE 2
City	:	ARDMORE
State	:	PA
Zip	:	19003-1413
Country	:	US
Telephone Number	:	302-750-0702
Fax Number	:

Provider Business Practice Location Address
First Line	:	63 W LANCASTER AVE
Second Line	:	SUITE 2
City	:	ARDMORE
State	:	PA
Zip	:	19003-1413
Country	:	US
Telephone Number	:	302-750-0702
Fax Number	:

Authorized Official
Title or Position	:	PARTNER / MANAGING DIRECTOR
Name	:	ANDEW PHILIP BURNS
Credential	:	MS
Telephone Number	:	302-750-0702

Provider Enumeration Date	:	09/15/2015
Last Update Date	:	09/15/2015

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Directions to “WELL-BEING CENTER ” Practice Location

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