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Organization

SPECTRA SUPPORT SERVICES, LLC

Active
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Organization

SPECTRA SUPPORT SERVICES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. MALEITA MARGUERITE OLSON LCSW (DIRECTOR/ CO-OWNER)
(484) 450-6476
Entity
Organization

Contact information

Practice address
390 REED RD FL 1, BROOMALL, PA 19008-4008
(484) 450-6476
(484) 450-6476
Mailing address
390 REED RD FL 1, BROOMALL, PA 19008-4008
(484) 450-6476
(484) 224-3398

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
101YP2500X
Professional Counselor
103K00000X
Behavior Analyst
BH000073
PA
104100000X
Social Worker
1041C0700X
Clinical Social Worker
Primary
106H00000X
Marriage & Family Therapist
225A00000X
Music Therapist
251S00000X
Community/Behavioral Health Agency
261QM1300X
Multi-Specialty Clinic/Center

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1027817150019
PA
05
1027817150020
PA
05
1027817150021
PA
05
1027817150022
PA
05
1027817150023
PA
05
1027817150024
PA
Enumeration date
06/20/2012
Last updated
04/02/2020
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