Healthcare Provider Details

I. General information

NPI: 1942372800
Provider Name (Legal Business Name): H.S.A. COUNSELING, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 02/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 E LOCUST ST
EPHRATA PA
17522-2717
US

IV. Provider business mailing address

PO BOX M
MIFFLIN PA
17058-0913
US

V. Phone/Fax

Practice location:
  • Phone: 717-394-5334
  • Fax: 717-738-2694
Mailing address:
  • Phone: 717-394-5334
  • Fax: 717-436-9818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number367073
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number367073
License Number StatePA

VIII. Authorized Official

Name: MR. MICHAEL SHAWN BRYAN SR.
Title or Position: EXECUTIVE DIRECTOR
Credential: B.A.
Phone: 717-394-5334