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General NPI Number Information
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NPI Number | 1780103184
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Entity Type | Organization
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Legal Business Name | SARA CZUCHNICKI MS LPC LLC
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Dates
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Enumeration Date | 09/17/2017
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Last Update Date | 09/17/2017
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Provider Practice Location Address
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Address Line | 561 OLD W CHOCOLATE AVE
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City | HERSHEY
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State | PA
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Zip | 17033-1676
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Country | US
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Telephone | 717-559-5045
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Fax |
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Provider Business Mailing Address
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Address Line | 659 CATTAIL DR
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City | HARRISBURG
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State | PA
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Zip | 17111-3872
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Country | US
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Telephone | 724-622-9418
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SARA CZUCHNICKI
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Credential | LPC
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Telephone | 717-559-5045
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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 | PC006839
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License Number State | PA
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