Provider Demographics
NPI:1184284028
Name:CENTER FOR HEALING AND DEVELOPMENT, PLLC
Entity type:Organization
Organization Name:CENTER FOR HEALING AND DEVELOPMENT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTEIRO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:215-874-4225
Mailing Address - Street 1:118 W HAINES ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-2708
Mailing Address - Country:US
Mailing Address - Phone:267-563-0722
Mailing Address - Fax:
Practice Address - Street 1:111 PRESIDENTIAL BLVD STE 237
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1012
Practice Address - Country:US
Practice Address - Phone:215-874-4225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty