Provider Demographics
NPI:1174847263
Name:CHILD AND ADOLESCENT COUNSELING SERVICES OF S.E. PA, LLC
Entity Type:Organization
Organization Name:CHILD AND ADOLESCENT COUNSELING SERVICES OF S.E. PA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRINH (ANGELA)
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN-SMALLWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC
Authorized Official - Phone:610-764-8655
Mailing Address - Street 1:220 W GAY ST FL 3
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-2917
Mailing Address - Country:US
Mailing Address - Phone:610-764-8655
Mailing Address - Fax:610-692-2011
Practice Address - Street 1:220 W GAY ST FL 3
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-2917
Practice Address - Country:US
Practice Address - Phone:610-764-8655
Practice Address - Fax:610-692-2011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-18
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003813106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty