Healthcare Provider Details

I. General information

NPI: 1629075791
Provider Name (Legal Business Name): ACADIA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1817 OLDE HOMESTEAD LN SUITE 201
LANCASTER PA
17601-6751
US

IV. Provider business mailing address

1817 OLDE HOMESTEAD LN SUITE 201
LANCASTER PA
17601-6751
US

V. Phone/Fax

Practice location:
  • Phone: 717-394-3466
  • Fax:
Mailing address:
  • Phone: 717-394-3466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC001784
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS004228L
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOP005962
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT006616L
License Number StatePA
# 5
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOC001760L
License Number StatePA
# 6
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSL001274L
License Number StatePA
# 7
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 8
Primary TaxonomyN
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number1361060308
License Number StatePA

VIII. Authorized Official

Name: SUSAN GAYLE BUSSANMAS
Title or Position: ADMINISTRATIVE DIRECTOR
Credential:
Phone: 717-394-3466