Provider Demographics
NPI:1548928476
Name:STEPHEN MILBURN LPC LLC
Entity type:Organization
Organization Name:STEPHEN MILBURN LPC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MILBURN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:267-945-1617
Mailing Address - Street 1:2 BALA PLLAZA
Mailing Address - Street 2:STE. 300
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004
Mailing Address - Country:US
Mailing Address - Phone:267-945-1617
Mailing Address - Fax:215-754-4141
Practice Address - Street 1:2 BALA PLLAZA
Practice Address - Street 2:STE. 300
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004
Practice Address - Country:US
Practice Address - Phone:267-945-1617
Practice Address - Fax:215-754-4141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-08
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)