| Organization Name: | MAIN LINE COUNSELING CENTER, LLC |
| NPI Number: | 1023363330 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RACHEL CHANDLER (LICENSED CLINICAL SOCIAL WORKER) |
| Mailing Address: | 104 1/2 Forrest Ave Suite 27 Narberth |
| State: | PA US |
| Postal Code: | 190722220 |
| Phone Number: | 6106642524 |
| Fax Number: | |
| NPI Enumeration Date: | 07/24/2012 |
| NPI Last Update Date: | 07/24/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | PC006228 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |