Healthcare Provider Details

I. General information

NPI: 1366481152
Provider Name (Legal Business Name): JAIME HETSKO MA, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAIME RIDILLA MA, LPC

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1755 OREGON PIKE STE 200
LANCASTER PA
17601-4272
US

IV. Provider business mailing address

1755 OREGON PIKE STE 200
LANCASTER PA
17601-4272
US

V. Phone/Fax

Practice location:
  • Phone: 717-581-5255
  • Fax:
Mailing address:
  • Phone: 717-581-5255
  • Fax: 717-581-5256

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC004047
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC004047
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: