Healthcare Provider Details

I. General information

NPI: 1063324507
Provider Name (Legal Business Name): NATHAN PATRICK STERRY LSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 WILLOW VALLEY SQ STE 210
LANCASTER PA
17602-4859
US

IV. Provider business mailing address

200 WILLOW VALLEY SQ STE 210
LANCASTER PA
17602-4859
US

V. Phone/Fax

Practice location:
  • Phone: 717-478-3411
  • Fax:
Mailing address:
  • Phone: 717-478-3411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberSW141166
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: