Provider Demographics
NPI:1528237179
Name:GENEVA LEARNING CONSULTANTS, PA
Entity type:Organization
Organization Name:GENEVA LEARNING CONSULTANTS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:OLDHAM
Authorized Official - Last Name:IKLE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:910-793-6144
Mailing Address - Street 1:1606 WELLINGTON AVE.
Mailing Address - Street 2:UNIT H
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7704
Mailing Address - Country:US
Mailing Address - Phone:910-793-6144
Mailing Address - Fax:910-793-6140
Practice Address - Street 1:1606 WELLINGTON AVE.
Practice Address - Street 2:UNIT H
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7704
Practice Address - Country:US
Practice Address - Phone:910-793-6144
Practice Address - Fax:910-793-6140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-28
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3302103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty