Provider Demographics
NPI:1952047987
Name:PENLLYN COUNSELING ASSOCIATES LLC
Entity Type:Organization
Organization Name:PENLLYN COUNSELING ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:F
Authorized Official - Last Name:KURTIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:215-292-8437
Mailing Address - Street 1:341 CASALS PL
Mailing Address - Street 2:
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-2735
Mailing Address - Country:US
Mailing Address - Phone:215-292-8437
Mailing Address - Fax:
Practice Address - Street 1:589 SKIPPACK PIKE STE 303
Practice Address - Street 2:
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-2159
Practice Address - Country:US
Practice Address - Phone:215-292-8437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-11
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty