Healthcare Provider Details

I. General information

NPI: 1750772265
Provider Name (Legal Business Name): MARCIA JOHNSON-REINHART LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2015
Last Update Date: 04/25/2022
Certification Date: 04/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 5TH AVE
CHAMBERSBURG PA
17201-4219
US

IV. Provider business mailing address

22 ST PAUL DR STE 200
CHAMBERSBURG PA
17201-1033
US

V. Phone/Fax

Practice location:
  • Phone: 717-709-7930
  • Fax: 717-709-7931
Mailing address:
  • Phone: 717-709-7922
  • Fax: 717-263-2055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number12076
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW-018581
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: