Provider Demographics
NPI:1033669601
Name:CENTER FOR PSYCHOLOGICAL HEALTH AND WELLNESS, LLC
Entity Type:Organization
Organization Name:CENTER FOR PSYCHOLOGICAL HEALTH AND WELLNESS, LLC
Other - Org Name:HEIDI RAMSBOTTOM PHD
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER AND PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:M
Authorized Official - Last Name:RAMSBOTTOM
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:717-468-5308
Mailing Address - Street 1:122 W LANCASTER AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:SHILLINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19607-1881
Mailing Address - Country:US
Mailing Address - Phone:717-468-5308
Mailing Address - Fax:
Practice Address - Street 1:122 W LANCASTER AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:SHILLINGTON
Practice Address - State:PA
Practice Address - Zip Code:19607-1881
Practice Address - Country:US
Practice Address - Phone:717-468-5308
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-07
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS017332103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty