Provider Demographics
NPI:1548959380
Name:PEWTER THERAPY SERVICES, LLC
Entity type:Organization
Organization Name:PEWTER THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:LARKIN
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:856-359-4432
Mailing Address - Street 1:30 LEEDS POINT RD
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-4206
Mailing Address - Country:US
Mailing Address - Phone:856-313-7793
Mailing Address - Fax:
Practice Address - Street 1:87 E 2ND ST
Practice Address - Street 2:
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-3316
Practice Address - Country:US
Practice Address - Phone:856-359-4432
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-08
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty