Healthcare Provider Details

I. General information

NPI: 1194602979
Provider Name (Legal Business Name): JACQUELINE CONCEPCION LAPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2025
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 N MARKET ST STE 400
LANCASTER PA
17603-4875
US

IV. Provider business mailing address

1803 OREGON PIKE
LANCASTER PA
17601-6401
US

V. Phone/Fax

Practice location:
  • Phone: 717-560-9969
  • Fax: 717-560-9553
Mailing address:
  • Phone: 717-560-9969
  • Fax: 717-560-9553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberAPC001542
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: