Provider Demographics
NPI:1518388511
Name:PSIHOGIOS, IRENE P (MS, LPC, RPT)
Entity Type:Individual
Prefix:MRS
First Name:IRENE
Middle Name:P
Last Name:PSIHOGIOS
Suffix:
Gender:F
Credentials:MS, LPC, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 RENZ ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-1419
Mailing Address - Country:US
Mailing Address - Phone:484-802-7557
Mailing Address - Fax:
Practice Address - Street 1:233 E. LANCASTER AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:ARDMORE
Practice Address - State:PA
Practice Address - Zip Code:19003
Practice Address - Country:US
Practice Address - Phone:215-483-1360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007248101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional