Provider Demographics
NPI:1255754768
Name:NEWTOWN PSYCHOTHERAPY CENTER
Entity type:Organization
Organization Name:NEWTOWN PSYCHOTHERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL DIR
Authorized Official - Prefix:
Authorized Official - First Name:MARY ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:215-882-4445
Mailing Address - Street 1:1717 NEWTOWN-LANGHORNE ROAD
Mailing Address - Street 2:ONE SUMMIT SQUARE, SUITE 304
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1091
Mailing Address - Country:US
Mailing Address - Phone:215-882-4445
Mailing Address - Fax:
Practice Address - Street 1:1717 NEWTOWN-LANGHORNE ROAD
Practice Address - Street 2:ONE SUMMIT SQUARE, SUITE 304
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1091
Practice Address - Country:US
Practice Address - Phone:215-882-4445
Practice Address - Fax:267-759-6443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-04
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006681101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1962633487OtherINDIVIDUAL NPI
PA1962633487OtherINDIVIDUAL NPI
PA1497101927OtherSARA SCHNEIDER