Provider Demographics
NPI:1154195998
Name:RUMMERY, DANA LEAH (LPC, ATR-BC)
Entity type:Individual
Prefix:MRS
First Name:DANA
Middle Name:LEAH
Last Name:RUMMERY
Suffix:
Gender:F
Credentials:LPC, ATR-BC
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:LEAH
Other - Last Name:ZIMMERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:30 S 15TH ST STE 1550 #533008
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102
Mailing Address - Country:US
Mailing Address - Phone:214-709-7174
Mailing Address - Fax:
Practice Address - Street 1:30 S 15TH ST STE 533008
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-4826
Practice Address - Country:US
Practice Address - Phone:215-709-7174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-13
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA10-063221700000X
PAPC007049101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist