Provider Demographics
NPI:1285178590
Name:COUNSELING & NEUROFEEDBACK SERVICES LLC
Entity Type:Organization
Organization Name:COUNSELING & NEUROFEEDBACK SERVICES LLC
Other - Org Name:COUNSELING FOR YOU NOW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:PEARY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:570-493-0463
Mailing Address - Street 1:245 RIDGE ST
Mailing Address - Street 2:
Mailing Address - City:HONESDALE
Mailing Address - State:PA
Mailing Address - Zip Code:18431-1622
Mailing Address - Country:US
Mailing Address - Phone:570-493-0463
Mailing Address - Fax:570-253-4707
Practice Address - Street 1:602 CHURCH ST
Practice Address - Street 2:
Practice Address - City:HONESDALE
Practice Address - State:PA
Practice Address - Zip Code:18431-1864
Practice Address - Country:US
Practice Address - Phone:570-493-0463
Practice Address - Fax:570-253-4707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-06
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA008703251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health