Organization
LIFES PATH THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARA WENTZ MA, NCC, LPC (OWNER/ COUNSELOR)
(570) 561-6626
Entity
Organization
Contact information
Practice address
922 CHURCH ST FL 2, HONESDALE, PA 18431-1921
(570) 561-6626
(570) 904-8066
Mailing address
137 TRYON ST, HONESDALE, PA 18431-1126
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
PC010538
PA
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
PC010538
PA
Other
Enumeration date
08/06/2018
Last updated
08/06/2018
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