Healthcare Provider Details

I. General information

NPI: 1770906471
Provider Name (Legal Business Name): ROTHSVILLE COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2014
Last Update Date: 02/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2320 ROTHSVILLE RD SUITE 103A
LITITZ PA
17543-8215
US

IV. Provider business mailing address

2320 ROTHSVILLE RD SUITE 103A
LITITZ PA
17543-8215
US

V. Phone/Fax

Practice location:
  • Phone: 717-627-5133
  • Fax:
Mailing address:
  • Phone: 717-627-5133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC003536
License Number StatePA

VII. Legacy identifiers

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

VIII. Authorized Official

Name: STEPHANIE ARLENE SWANN
Title or Position: PSYCHOTHERAPIST
Credential: LPC
Phone: 717-314-2040