Provider Demographics
NPI:1538731492
Name:THE COUNSELING AND WELLNESS CENTER OF WYOMISSING
Entity type:Organization
Organization Name:THE COUNSELING AND WELLNESS CENTER OF WYOMISSING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ELON
Authorized Official - Middle Name:
Authorized Official - Last Name:GRUBER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:484-772-6488
Mailing Address - Street 1:124 JOHN ROBERT THOMAS DR
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2655
Mailing Address - Country:US
Mailing Address - Phone:484-772-6488
Mailing Address - Fax:
Practice Address - Street 1:124 JOHN ROBERT THOMAS DR
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2655
Practice Address - Country:US
Practice Address - Phone:484-772-6488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-12
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health