Healthcare Provider Details

I. General information

NPI: 1376531822
Provider Name (Legal Business Name): JAMES A HOUCK PLD LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4918 LOCUST LN
HARRISBURG PA
17109-4519
US

IV. Provider business mailing address

632 CUMBERLAND ST
LEBANON PA
17042-5230
US

V. Phone/Fax

Practice location:
  • Phone: 717-671-9610
  • Fax: 717-671-9680
Mailing address:
  • Phone: 717-273-1710
  • Fax: 717-273-1416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: