Provider Demographics
NPI:1053786863
Name:GEORG ASSOCIATES
Entity type:Organization
Organization Name:GEORG ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:LOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:GEORG
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:484-324-8370
Mailing Address - Street 1:440 W SEDGWICK ST
Mailing Address - Street 2:SUITE A106
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-3045
Mailing Address - Country:US
Mailing Address - Phone:484-324-8370
Mailing Address - Fax:
Practice Address - Street 1:1518 WALNUT ST
Practice Address - Street 2:SUITE 607
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-3419
Practice Address - Country:US
Practice Address - Phone:484-324-8370
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-04
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004689101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA12359148OtherNPI