Provider Demographics
NPI:1184879397
Name:COUNSELING ARTS OF MAXATAWNY LP
Entity type:Organization
Organization Name:COUNSELING ARTS OF MAXATAWNY LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:R
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:610-683-3301
Mailing Address - Street 1:PO BOX 45
Mailing Address - Street 2:
Mailing Address - City:MAXATAWNY
Mailing Address - State:PA
Mailing Address - Zip Code:19538-0045
Mailing Address - Country:US
Mailing Address - Phone:610-683-3301
Mailing Address - Fax:610-683-3351
Practice Address - Street 1:15895 KUTZTOWN ROAD
Practice Address - Street 2:
Practice Address - City:MERTZTOWN
Practice Address - State:PA
Practice Address - Zip Code:19539-0039
Practice Address - Country:US
Practice Address - Phone:610-683-3301
Practice Address - Fax:610-683-3351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-02
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA5675101YA0400X
PA5779101YA0400X
PAPC002448101YP2500X
PAPC002455101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty