Healthcare Provider Details

I. General information

NPI: 1578508438
Provider Name (Legal Business Name): JOHN MULDOON PHD, LPC, CAAP-2
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 EDGAR ST SUITE A
YORK PA
17403-2862
US

IV. Provider business mailing address

3550 CONCORD RD
YORK PA
17402-8626
US

V. Phone/Fax

Practice location:
  • Phone: 717-851-1500
  • Fax: 717-851-1515
Mailing address:
  • Phone: 717-851-6340
  • Fax: 717-851-6349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberPC004115
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC004115
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: