Healthcare Provider Details

I. General information

NPI: 1336717750
Provider Name (Legal Business Name): NOW SHE SOARS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2021
Last Update Date: 10/21/2021
Certification Date: 10/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

79 E MAIN ST STE 302
LITITZ PA
17543-1941
US

IV. Provider business mailing address

23 KREADY AVE
MILLERSVILLE PA
17551-2005
US

V. Phone/Fax

Practice location:
  • Phone: 717-455-0797
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
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: LESLIE BUNTING
Title or Position: OWNER
Credential: LCSW
Phone: 717-455-0797