Provider Demographics
NPI:1770366247
Name:GEIS, CARLY DEE (NCC, CAADC, LPC)
Entity type:Individual
Prefix:
First Name:CARLY
Middle Name:DEE
Last Name:GEIS
Suffix:
Gender:
Credentials:NCC, CAADC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 N WEST ST
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-2366
Mailing Address - Country:US
Mailing Address - Phone:215-345-5300
Mailing Address - Fax:
Practice Address - Street 1:500 N WEST ST
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2366
Practice Address - Country:US
Practice Address - Phone:215-345-5300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-17
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC016174101YM0800X
PAAA0004751419101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty