| Conshohocken Center For Emotional Health | |
|
20 E 2nd Ave Ste 100 Conshohocken PA 19428-1880 | |
| (610) 635-5677 | |
| (610) 828-4910 |
| Full Name | Conshohocken Center For Emotional Health |
|---|---|
| Speciality | Social Worker |
| Location | 20 E 2nd Ave Ste 100, Conshohocken, Pennsylvania |
| Authorized Official Name and Position | Carolyn M Fortenberry (BUSINESS OWNER) |
| Authorized Official Contact | 6106355677 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Conshohocken Center For Emotional Health 1101 New Dehaven St Conshohocken PA 19428-2742 Ph: (610) 635-5677 | Conshohocken Center For Emotional Health 20 E 2nd Ave Ste 100 Conshohocken PA 19428-1880 Ph: (610) 635-5677 |
| NPI Number | 1003363615 |
|---|---|
| Provider Enumeration Date | 09/01/2016 |
| Last Update Date | 11/01/2024 |
| Certification Date | 11/01/2024 |
| Medicare PECOS PAC ID | 0446539738 |
|---|---|
| Medicare Enrollment ID | O20161109000121 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003363615 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Sharon L Clarke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710098322 PECOS PAC ID: 4486714441 Enrollment ID: I20081120000317 |
| Provider Name | Carolyn M Fortenberry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215286273 PECOS PAC ID: 3779700190 Enrollment ID: I20140808000500 |
| Provider Name | Deborah Michelman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750756029 PECOS PAC ID: 6608211628 Enrollment ID: I20240229002949 |
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