Organization
THIBAULT COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES LAWRENCE THIBAULT LPC (OWNER/PSYCHOTHERAPIST)
(267) 918-6916
Entity
Organization
Contact information
Practice address
2049 NORTH STREET, PHILADELPHIA, PA 19130
(267) 918-6916
Mailing address
2049 NORTH STREET, PHILADELPHIA, PA 19130
(267) 918-6916
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
08/01/2019
Last updated
08/01/2019
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