Provider Demographics
NPI:1144902339
Name:BENT MOUNTAIN SPRINGS COUNSELING LLC
Entity type:Organization
Organization Name:BENT MOUNTAIN SPRINGS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:KEISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:VUONG
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC, LPCMH, NCC
Authorized Official - Phone:484-380-5490
Mailing Address - Street 1:502 W 7TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16502-1333
Mailing Address - Country:US
Mailing Address - Phone:484-380-5490
Mailing Address - Fax:
Practice Address - Street 1:5 CHRISTY DR STE 102
Practice Address - Street 2:
Practice Address - City:CHADDS FORD
Practice Address - State:PA
Practice Address - Zip Code:19317-9667
Practice Address - Country:US
Practice Address - Phone:484-380-5490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-07
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty