Provider Demographics
NPI:1366456790
Name:CEDAR CREST PSYCHOLOGICAL COUNSELING, P.C.
Entity Type:Organization
Organization Name:CEDAR CREST PSYCHOLOGICAL COUNSELING, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GEOFFREY
Authorized Official - Middle Name:K
Authorized Official - Last Name:SHERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, NCC, LPC
Authorized Official - Phone:610-437-4577
Mailing Address - Street 1:1605 N CEDAR CREST BLVD STE 520
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-2355
Mailing Address - Country:US
Mailing Address - Phone:610-437-4577
Mailing Address - Fax:610-437-6877
Practice Address - Street 1:1605 N CEDAR CREST BLVD STE 520
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-2355
Practice Address - Country:US
Practice Address - Phone:610-437-4577
Practice Address - Fax:610-437-6877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-007491L305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization