Provider Demographics
NPI:1992552582
Name:PURE LIFE COUNSELING, LLC
Entity type:Organization
Organization Name:PURE LIFE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR/ OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ZARAHIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PICHARDO
Authorized Official - Suffix:
Authorized Official - Credentials:MA , LPC
Authorized Official - Phone:610-890-9049
Mailing Address - Street 1:2120 HAMPDEN BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19604-1380
Mailing Address - Country:US
Mailing Address - Phone:717-964-8325
Mailing Address - Fax:484-220-1054
Practice Address - Street 1:2120 HAMPDEN BLVD STE 2
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19604-1380
Practice Address - Country:US
Practice Address - Phone:610-890-9049
Practice Address - Fax:717-420-1501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-02
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty