Provider Demographics
NPI:1588946412
Name:KAHL, POLLY (MA, LPC)
Entity type:Individual
Prefix:
First Name:POLLY
Middle Name:
Last Name:KAHL
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2130 PENN AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19609-1600
Mailing Address - Country:US
Mailing Address - Phone:610-478-8686
Mailing Address - Fax:
Practice Address - Street 1:2130 PENN AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19609-1600
Practice Address - Country:US
Practice Address - Phone:610-478-8686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC001017101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health