# IVY THERAPIST LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346806601
- **Authorized official:** SUE ELLEN ZHANG LPC (OWNER)
- **Authorized official phone:** (267) 606-0424

## Contact information

- **Practice address:** 8600 W CHESTER PIKE STE 108, UPPER DARBY, PA 19082-2629
- **Practice address phone:** (267) 606-0424
- **Mailing address:** 239 ROCK GLEN RD, WYNNEWOOD, PA 19096-3215
- **Mailing address phone:** (267) 971-7805

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 05/13/2019
- **Last updated:** 05/13/2019