Healthcare Provider Details

I. General information

NPI: 1588495477
Provider Name (Legal Business Name): KAITLYN RHUBRIGHT-FYE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2024
Last Update Date: 08/12/2024
Certification Date: 08/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 S 9TH ST
LEBANON PA
17042-5104
US

IV. Provider business mailing address

410 N PRINCE ST
LANCASTER PA
17603-3010
US

V. Phone/Fax

Practice location:
  • Phone: 717-273-5992
  • Fax: 717-273-5995
Mailing address:
  • Phone: 171-560-7917
  • Fax: 717-560-6452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC017434
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: