Provider Demographics
NPI:1497837355
Name:IVYLAND COUNSELING CENTER, INC.
Entity type:Organization
Organization Name:IVYLAND COUNSELING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:HEINRICHS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:215-444-9204
Mailing Address - Street 1:1210 OLD YORK RD
Mailing Address - Street 2:STE 202
Mailing Address - City:WARMINSTER
Mailing Address - State:PA
Mailing Address - Zip Code:18974-2013
Mailing Address - Country:US
Mailing Address - Phone:215-444-9204
Mailing Address - Fax:215-444-9206
Practice Address - Street 1:1210 OLD YORK RD
Practice Address - Street 2:STE 202
Practice Address - City:WARMINSTER
Practice Address - State:PA
Practice Address - Zip Code:18974-2013
Practice Address - Country:US
Practice Address - Phone:215-444-9204
Practice Address - Fax:215-444-9206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS015521103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty