Provider Demographics
NPI:1356883698
Name:SYNERGY CONSULTANTS & PSYCHOTHERAPY PRACTICE
Entity type:Organization
Organization Name:SYNERGY CONSULTANTS & PSYCHOTHERAPY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARGO
Authorized Official - Middle Name:LEONA
Authorized Official - Last Name:LEWIS-JAH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD,LCSW,MED,MOML
Authorized Official - Phone:610-800-9524
Mailing Address - Street 1:237 DUMONT RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19804-1001
Mailing Address - Country:US
Mailing Address - Phone:610-800-9524
Mailing Address - Fax:302-351-6830
Practice Address - Street 1:301 OLD DUPONT ROAD SUITE A
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19804-1000
Practice Address - Country:US
Practice Address - Phone:302-503-2273
Practice Address - Fax:302-351-6830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-16
Last Update Date:2018-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00014151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty