MEDICARE: ASHLEY HOPE MAHDAVI 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
1	101YP2500X	Professional Counselor	PC006443	PA

General Provider Information

NPI Number	:	1609213081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY HOPE MAHDAVI LPC

Provider Business Mailing Address
First Line	:	3920 MARKET ST
Second Line	:	SUITE 201
City	:	CAMP HILL
State	:	PA
Zip	:	17011-4202
Country	:	US
Telephone Number	:	717-798-8965
Fax Number	:

Provider Business Practice Location Address
First Line	:	3920 MARKET ST
Second Line	:	SUITE 201
City	:	CAMP HILL
State	:	PA
Zip	:	17011-4202
Country	:	US
Telephone Number	:	717-798-8965
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2013
Last Update Date	:	10/22/2014

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Directions to “ ASHLEY HOPE MAHDAVI LPC” Practice Location

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