Provider Demographics
NPI:1376912923
Name:TELEMENTAL HEALTH NETWORK, LLC
Entity Type:Organization
Organization Name:TELEMENTAL HEALTH NETWORK, LLC
Other - Org Name:VIRTUAL SCHOOL COUNSELOR NETWORK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:AZZOLINA
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:484-245-4455
Mailing Address - Street 1:650 S GREENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-9800
Mailing Address - Country:US
Mailing Address - Phone:484-245-4455
Mailing Address - Fax:
Practice Address - Street 1:650 S GREENWOOD AVE
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-9800
Practice Address - Country:US
Practice Address - Phone:484-245-4455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-24
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchoolGroup - Multi-Specialty