Healthcare Provider Details

I. General information

NPI: 1831818145
Provider Name (Legal Business Name): DEANNA L UNDERKOFFLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2022
Last Update Date: 08/22/2022
Certification Date: 08/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 W POMFRET ST
CARLISLE PA
17013-3217
US

IV. Provider business mailing address

63 SILVER CROWN DR
MECHANICSBURG PA
17050-1638
US

V. Phone/Fax

Practice location:
  • Phone: 717-258-0214
  • Fax:
Mailing address:
  • Phone: 717-599-0925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC014765
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: