Healthcare Provider Details

I. General information

NPI: 1518058767
Provider Name (Legal Business Name): PSYCHOLOGICAL ASSOCIATES OF LANCASTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 01/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2741 LITITZ PIKE 1ST FL
LANCASTER PA
17601-3377
US

IV. Provider business mailing address

2741 LITITZ PIKE 1ST FL
LANCASTER PA
17601
US

V. Phone/Fax

Practice location:
  • Phone: 717-569-8511
  • Fax: 717-569-8513
Mailing address:
  • Phone: 717-569-8511
  • Fax: 717-569-8513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: MS. JENNIFER B DOWNEY
Title or Position: SECRETARY TREASURER
Credential: LICENSED PSYCHOLOGIS
Phone: 717-569-8511