Provider Demographics
NPI:1851895015
Name:COUPLES AND FAMILY WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:COUPLES AND FAMILY WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERSHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:610-889-2089
Mailing Address - Street 1:1034 BEAUMONT RD
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:PA
Mailing Address - Zip Code:19312-2040
Mailing Address - Country:US
Mailing Address - Phone:161-088-9208
Mailing Address - Fax:610-889-9247
Practice Address - Street 1:1034 BEAUMONT RD
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:PA
Practice Address - Zip Code:19312-2040
Practice Address - Country:US
Practice Address - Phone:161-088-9208
Practice Address - Fax:610-889-9247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-22
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1942268461OtherNPPES