Healthcare Provider Details

I. General information

NPI: 1285192807
Provider Name (Legal Business Name): ZENAIDA NIEVES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ZENAIDA GUZMAN

II. Dates (important events)

Enumeration Date: 03/04/2019
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2555 CAPE HORN ROAD
RED LION PA
17356
US

IV. Provider business mailing address

2555 CAPE HORN ROAD
RED LION PA
17356
US

V. Phone/Fax

Practice location:
  • Phone: 717-600-0900
  • Fax: 717-600-0910
Mailing address:
  • Phone: 717-600-0900
  • Fax: 717-600-0910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberBH006994
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: