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General NPI Number Information
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NPI Number | 1316379605
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Entity Type | Organization
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Legal Business Name | BETHANY CHRISTIAN SERVICES
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Dates
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Enumeration Date | 08/08/2013
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Last Update Date | 08/08/2013
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Provider Practice Location Address
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Address Line | 2101 N FRONT ST
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City | HARRISBURG
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State | PA
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Zip | 17110-1086
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Country | US
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Telephone | 717-368-0792
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Fax | 717-399-3543
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Provider Business Mailing Address
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Address Line | 2101 N FRONT ST
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City | HARRISBURG
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State | PA
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Zip | 17110-1086
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Country | US
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Telephone | 717-368-0792
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Fax | 717-399-3543
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Authorized Official
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Title or Position | BRANCH DIRECTOR
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Name | MARK UNGER
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Credential |
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Telephone | 717-368-0792
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC004286
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License Number State | PA
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