Healthcare Provider Details

I. General information

NPI: 1366372955
Provider Name (Legal Business Name): JONATHAN CHAMBERS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2026
Last Update Date: 05/23/2026
Certification Date: 05/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1513 CEDAR CLIFF DR STE 200
CAMP HILL PA
17011-7721
US

IV. Provider business mailing address

1513 CEDAR CLIFF DR STE 200
CAMP HILL PA
17011-7721
US

V. Phone/Fax

Practice location:
  • Phone: 484-509-1079
  • Fax:
Mailing address:
  • Phone: 484-509-1079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPC002388
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: