Healthcare Provider Details

I. General information

NPI: 1134853674
Provider Name (Legal Business Name): BALDACCI BEHAVIORAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2022
Last Update Date: 07/11/2022
Certification Date: 07/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1741 CONARD RD
LANCASTER PA
17602-1371
US

IV. Provider business mailing address

1741 CONARD RD
LANCASTER PA
17602-1371
US

V. Phone/Fax

Practice location:
  • Phone: 717-824-7661
  • Fax:
Mailing address:
  • Phone: 717-824-7661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: HEIDI BECHTOLDT BALDACCI
Title or Position: PSYCHOLOGIST
Credential: PHD
Phone: 717-824-7661