Healthcare Provider Details

I. General information

NPI: 1497619811
Provider Name (Legal Business Name): SUPPORTIVE PATHWAYS COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

86 CHESTNUT GROVE RD
CONESTOGA PA
17516-9316
US

IV. Provider business mailing address

86 CHESTNUT GROVE RD
CONESTOGA PA
17516-9316
US

V. Phone/Fax

Practice location:
  • Phone: 717-584-4406
  • Fax:
Mailing address:
  • Phone: 717-584-4406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: LAURA HANK
Title or Position: LCSW, OUTPATIENT THERAPIST
Credential: LCSW
Phone: 717-584-4406