Provider Demographics
NPI:1861840928
Name:HEATHER DAVIDSON COUNSELING LLC
Entity type:Organization
Organization Name:HEATHER DAVIDSON COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INDIVIDUAL & COUPLES THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIDSON
Authorized Official - Suffix:
Authorized Official - Credentials:EDM, MA, LPC, CST
Authorized Official - Phone:215-300-5944
Mailing Address - Street 1:319 PRICE AVE
Mailing Address - Street 2:
Mailing Address - City:NARBERTH
Mailing Address - State:PA
Mailing Address - Zip Code:19072-1917
Mailing Address - Country:US
Mailing Address - Phone:215-300-5944
Mailing Address - Fax:
Practice Address - Street 1:319 PRICE AVE
Practice Address - Street 2:
Practice Address - City:NARBERTH
Practice Address - State:PA
Practice Address - Zip Code:19072-1917
Practice Address - Country:US
Practice Address - Phone:215-300-5944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-31
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007206251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health