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General NPI Number Information
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NPI Number | 1639201023
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Entity Type | Organization
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Legal Business Name | GREENCASTLE FAMILY PRACTICE, PC
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 50 EASTERN AVE SUITE 115
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City | GREENCASTLE
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State | PA
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Zip | 17225-1100
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Country | US
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Telephone | 717-597-0095
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Fax | 717-597-3147
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Provider Business Mailing Address
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Address Line | 50 EASTERN AVE SUITE 135
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City | GREENCASTLE
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State | PA
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Zip | 17225-1100
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Country | US
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Telephone | 717-597-0095
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Fax | 717-597-3147
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Authorized Official
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Title or Position | EXEC ASSISTANT
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Name | MRS. JENNIFFER L SHOWALTER
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Credential |
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Telephone | 223-465-2025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | PS008907L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | PC000234
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License Number State | PA
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