Provider Demographics
NPI:1285259259
Name:CANOPY COUNSELING UNLIMITED
Entity type:Organization
Organization Name:CANOPY COUNSELING UNLIMITED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:M
Authorized Official - Last Name:KOEHLER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, BSL
Authorized Official - Phone:610-229-9029
Mailing Address - Street 1:8 STIRLING WAY
Mailing Address - Street 2:
Mailing Address - City:CHADDS FORD
Mailing Address - State:PA
Mailing Address - Zip Code:19317-9413
Mailing Address - Country:US
Mailing Address - Phone:610-812-6881
Mailing Address - Fax:
Practice Address - Street 1:210 W FRONT ST STE 214
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-3149
Practice Address - Country:US
Practice Address - Phone:610-229-9029
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-15
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty