Provider Demographics
NPI:1861025678
Name:PASSIONATE THOUGHTS BEHAVIORAL COUNSELING AND EVALUATION SERVICES, LLC
Entity Type:Organization
Organization Name:PASSIONATE THOUGHTS BEHAVIORAL COUNSELING AND EVALUATION SERVICES, LLC
Other - Org Name:PASSIONATE THOUGHTS BEHAVIORAL COUNSELING AND EVALUATION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BCBA, LPC, LBS
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-310-9450
Mailing Address - Street 1:181 FABER CIR
Mailing Address - Street 2:
Mailing Address - City:TANNERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18372-9086
Mailing Address - Country:US
Mailing Address - Phone:908-310-9450
Mailing Address - Fax:866-927-4178
Practice Address - Street 1:3201 HIGHFIELD DR
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-1113
Practice Address - Country:US
Practice Address - Phone:908-310-9450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-20
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1032252400002Medicaid