Provider Demographics
NPI:1871130948
Name:CENTER FOR PSYCHOLOGICAL WELLNESS AND CHANGE LLC
Entity type:Organization
Organization Name:CENTER FOR PSYCHOLOGICAL WELLNESS AND CHANGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIFEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:ESTRADA-CURRIE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:610-638-6100
Mailing Address - Street 1:6081 HAMILTON BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18106-9801
Mailing Address - Country:US
Mailing Address - Phone:610-638-6100
Mailing Address - Fax:610-638-6101
Practice Address - Street 1:6081 HAMILTON BLVD STE 600
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18106-9801
Practice Address - Country:US
Practice Address - Phone:610-638-6100
Practice Address - Fax:610-638-6101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-07
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty