Provider Demographics
NPI:1396399697
Name:THE COUNSELING AND WELLNESS CENTER OF WYOMISSING
Entity Type:Organization
Organization Name:THE COUNSELING AND WELLNESS CENTER OF WYOMISSING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OF THE PRACTICE/PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ELON
Authorized Official - Middle Name:MEGAN
Authorized Official - Last Name:GRUBER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:610-570-1133
Mailing Address - Street 1:560 VAN REED RD STE 206
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1799
Mailing Address - Country:US
Mailing Address - Phone:610-570-1133
Mailing Address - Fax:
Practice Address - Street 1:560 VAN REED RD STE 206
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1799
Practice Address - Country:US
Practice Address - Phone:610-570-1133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-25
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health