Provider Demographics
NPI:1457657124
Name:ABOVE AND BEYOND COUNSELING SERVICES OF PA, LLC
Entity Type:Organization
Organization Name:ABOVE AND BEYOND COUNSELING SERVICES OF PA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:WYNANTE
Authorized Official - Middle Name:
Authorized Official - Last Name:SEWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:717-679-7142
Mailing Address - Street 1:685 BLOOMFIELD AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:VERONA
Mailing Address - State:NJ
Mailing Address - Zip Code:07044-1630
Mailing Address - Country:US
Mailing Address - Phone:973-239-0948
Mailing Address - Fax:973-696-8323
Practice Address - Street 1:1655 MANHEIM PIKE
Practice Address - Street 2:OB-4
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-3061
Practice Address - Country:US
Practice Address - Phone:973-239-0948
Practice Address - Fax:973-696-8323
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ABOVE AND BEYOND COUNSELING SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-01-28
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC003508001041C0700X
NJ37FI00160200106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty