Provider Demographics
NPI:1114305984
Name:FAMILY MARRIAGE AND LIFE COUNSELING INC.
Entity Type:Organization
Organization Name:FAMILY MARRIAGE AND LIFE COUNSELING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GALANTI
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:484-838-0819
Mailing Address - Street 1:15525 KUTZTOWN RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:KUTZTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19530-9303
Mailing Address - Country:US
Mailing Address - Phone:610-683-3044
Mailing Address - Fax:484-290-2330
Practice Address - Street 1:15525 KUTZTOWN RD
Practice Address - Street 2:SUITE A
Practice Address - City:KUTZTOWN
Practice Address - State:PA
Practice Address - Zip Code:19530-9303
Practice Address - Country:US
Practice Address - Phone:610-683-3044
Practice Address - Fax:484-290-2330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-13
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA006181101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty