Provider Demographics
NPI:1760254650
Name:EMOTIONALLY REWIRED, LLC
Entity Type:Organization
Organization Name:EMOTIONALLY REWIRED, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/LICENSED CMH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:TATAR-PICKERSGILL
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC, NCC
Authorized Official - Phone:267-577-1155
Mailing Address - Street 1:115 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-2024
Mailing Address - Country:US
Mailing Address - Phone:267-577-1155
Mailing Address - Fax:
Practice Address - Street 1:25 E BRIDGE ST
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:PA
Practice Address - Zip Code:19067-7129
Practice Address - Country:US
Practice Address - Phone:267-797-5029
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-25
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No251S00000XAgenciesCommunity/Behavioral Health
No251V00000XAgenciesVoluntary or Charitable