Provider Demographics
NPI:1629371109
Name:DESTINY COUNSELING & CHRISTIAN THERAPY SERVICES, LLC
Entity Type:Organization
Organization Name:DESTINY COUNSELING & CHRISTIAN THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ LICENSED PROFESSIONAL COUNSE
Authorized Official - Prefix:
Authorized Official - First Name:KWABENA BOBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:AMANKWATIA
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:610-751-6091
Mailing Address - Street 1:5842 TOVA CIR
Mailing Address - Street 2:
Mailing Address - City:MACUNGIE
Mailing Address - State:PA
Mailing Address - Zip Code:18062-8460
Mailing Address - Country:US
Mailing Address - Phone:610-751-6091
Mailing Address - Fax:
Practice Address - Street 1:5842 TOVA CIR
Practice Address - Street 2:
Practice Address - City:MACUNGIE
Practice Address - State:PA
Practice Address - Zip Code:18062-8460
Practice Address - Country:US
Practice Address - Phone:610-751-6091
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-06
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004101101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty