Healthcare Provider Details

I. General information

NPI: 1366676868
Provider Name (Legal Business Name): STEVEN KYLE VILLBRANDT MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2009
Last Update Date: 04/25/2024
Certification Date: 04/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HIGHLANDS DR STE 205
LITITZ PA
17543-7692
US

IV. Provider business mailing address

2048 SILVER LN
WILLOW STREET PA
17584-9729
US

V. Phone/Fax

Practice location:
  • Phone: 717-625-0025
  • Fax: 717-625-0009
Mailing address:
  • Phone: 717-625-0025
  • Fax: 717-625-0009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional 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:
Title or Position:
Credential:
Phone: