Provider Demographics
NPI:1053046300
Name:THE LANCASTER CENTER FOR TRAUMA AND DISORDERED EATING
Entity Type:Organization
Organization Name:THE LANCASTER CENTER FOR TRAUMA AND DISORDERED EATING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANASTACIA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:GOLEMB-FELLOWS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:484-326-1402
Mailing Address - Street 1:257 DELP RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-3907
Mailing Address - Country:US
Mailing Address - Phone:484-326-1402
Mailing Address - Fax:
Practice Address - Street 1:257 DELP RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-3907
Practice Address - Country:US
Practice Address - Phone:484-326-1402
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-20
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty