Provider Demographics
NPI:1003360751
Name:MCCAIN, TAISA
Entity Type:Individual
Prefix:
First Name:TAISA
Middle Name:
Last Name:MCCAIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2351 FREEDOM WAY
Mailing Address - Street 2:STE 200
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9282
Mailing Address - Country:US
Mailing Address - Phone:717-600-0900
Mailing Address - Fax:717-600-0910
Practice Address - Street 1:20B E ROSEVILLE RD
Practice Address - Street 2:STERLING PLACE
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-3868
Practice Address - Country:US
Practice Address - Phone:717-560-2372
Practice Address - Fax:717-560-2027
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-11
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH001835101YM0800X
PAPC010874101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health