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NPI Code Detail

MEDICARE: MS. STACY LYNN AUGUST MSW

MEDICARE: MS. STACY LYNN AUGUST MSW
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
1104100000XSocial WorkerSW0137191PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1348654OTHERMHN OF CA

General Provider Information

NPI Number : 1649269895
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. STACY LYNN AUGUST MSW
Provider Business Mailing Address
First Line : 200 NORTH 7TH STREET
Second Line :
City : LEBANON
State : PA
Zip : 17046
Country : US
Telephone Number : 717-273-1710
Fax Number : 717-273-1416
Provider Business Practice Location Address
First Line : 40 PEARL ST
Second Line :
City : LANCASTER
State : PA
Zip : 17603-3231
Country : US
Telephone Number : 717-393-8081
Fax Number : 717-397-8414
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2005
Last Update Date : 07/08/2007

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