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NPI Code Detail

MEDICARE: MR. BRIAN SCOTT HACKMAN LPC, CAC DIPLOMATE

MEDICARE: MR. BRIAN SCOTT HACKMAN LPC, CAC DIPLOMATE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor4561PA
2101YP2500XProfessional CounselorPC002446PA

General Provider Information

NPI Number : 1174557144
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRIAN SCOTT HACKMAN LPC, CAC DIPLOMATE
Provider Business Mailing Address
First Line : PO BOX 202
Second Line :
City : PICTURE ROCKS
State : PA
Zip : 17762-0202
Country : US
Telephone Number : 570-584-2116
Fax Number : 570-322-8026
Provider Business Practice Location Address
First Line : 435 W 4TH ST
Second Line :
City : WILLIAMSPORT
State : PA
Zip : 17701-6001
Country : US
Telephone Number : 570-322-7873
Fax Number : 570-322-8026
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2006
Last Update Date : 09/11/2025

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