Provider Demographics
NPI:1497126098
Name:INTERSECTIONAL LIFE COUNSELING AND PSYCHOLOGY LLC
Entity Type:Organization
Organization Name:INTERSECTIONAL LIFE COUNSELING AND PSYCHOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELISABETH
Authorized Official - Middle Name:EVE SCROGGIN
Authorized Official - Last Name:YAELINGH-SCOFFINS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:412-533-5150
Mailing Address - Street 1:135 N DUKE ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2815
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:135 N DUKE ST
Practice Address - Street 2:SUITE 1
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2815
Practice Address - Country:US
Practice Address - Phone:412-533-5150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-08
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS017478261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)