Healthcare Provider Details

I. General information

NPI: 1437252517
Provider Name (Legal Business Name): COMMUNITY COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 09/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

239 W PHILADELPHIA ST
YORK PA
17401
US

IV. Provider business mailing address

PO BOX 7726
YORK PA
17404-0726
US

V. Phone/Fax

Practice location:
  • Phone: 717-845-2425
  • Fax: 717-845-2682
Mailing address:
  • Phone: 717-845-2425
  • Fax: 717-845-2682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. DEWANA LYNN HALL
Title or Position: AGENCY DIRECTOR
Credential: MHS LPC CAC CCJP
Phone: 717-845-2425