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NPI Code Detail

MEDICARE: MRS. ALTA LANDIS MS, LPC

MEDICARE: MRS. ALTA LANDIS MS, LPC
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
1101YP2500XProfessional CounselorPC002637PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1810884OTHERPAHIGHMARK BLUE SHIELD
250056087OTHERPACAPITALBLUECROSS

General Provider Information

NPI Number : 1417971128
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ALTA LANDIS MS, LPC
Provider Business Mailing Address
First Line : 1803 OREGON PIKE
Second Line :
City : LANCASTER
State : PA
Zip : 17601-6401
Country : US
Telephone Number : 717-560-9969
Fax Number : 717-560-9553
Provider Business Practice Location Address
First Line : 1803 OREGON PIKE
Second Line :
City : LANCASTER
State : PA
Zip : 17601-6401
Country : US
Telephone Number : 717-560-9969
Fax Number : 717-560-9553
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2006
Last Update Date : 07/08/2007

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