Provider Demographics
NPI:1396058061
Name:PENNSYLVANIA COUNSELING CENTER INC
Entity type:Organization
Organization Name:PENNSYLVANIA COUNSELING CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:JANN
Authorized Official - Suffix:SR
Authorized Official - Credentials:PHD
Authorized Official - Phone:215-378-0471
Mailing Address - Street 1:51 BAILEY DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON CROSSING
Mailing Address - State:PA
Mailing Address - Zip Code:18977-1007
Mailing Address - Country:US
Mailing Address - Phone:215-378-0471
Mailing Address - Fax:
Practice Address - Street 1:6 PENNS TRL
Practice Address - Street 2:SUITE 216
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1889
Practice Address - Country:US
Practice Address - Phone:215-378-0471
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-22
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS004443L261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)