Provider Demographics
NPI:1932976271
Name:MOMENT OF CLARITY PSYCHOTHERAPY AND CONSULTATION
Entity Type:Organization
Organization Name:MOMENT OF CLARITY PSYCHOTHERAPY AND CONSULTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TYLYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:COFER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:484-202-0522
Mailing Address - Street 1:6034 HAMILTON BLVD # 1060
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18106-9754
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6034 HAMILTON BLVD # 1060
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18106-9754
Practice Address - Country:US
Practice Address - Phone:484-488-7989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-06
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty