Healthcare Provider Details

I. General information

NPI: 1427246495
Provider Name (Legal Business Name): MARK CAMERON PENTZ LPC, CACD, CHT, NLP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2007
Last Update Date: 10/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 E KING ST
YORK PA
17403-2171
US

IV. Provider business mailing address

220 E KING ST
YORK PA
17403-2171
US

V. Phone/Fax

Practice location:
  • Phone: 717-843-4357
  • Fax: 717-854-0000
Mailing address:
  • Phone: 717-843-4357
  • Fax: 717-854-0000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number4796
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC003453
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: