Provider Demographics
NPI:1861977720
Name:THERAPY CONCIERGE
Entity type:Organization
Organization Name:THERAPY CONCIERGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SULT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:302-897-7789
Mailing Address - Street 1:516 DANIELS CT
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-1178
Mailing Address - Country:US
Mailing Address - Phone:302-319-3040
Mailing Address - Fax:
Practice Address - Street 1:516 DANIELS CT
Practice Address - Street 2:
Practice Address - City:BEAR
Practice Address - State:DE
Practice Address - Zip Code:19701-1178
Practice Address - Country:US
Practice Address - Phone:302-319-3040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-26
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty