Provider Demographics
NPI:1114265543
Name:WINDING CREEK COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:WINDING CREEK COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:R
Authorized Official - Last Name:FARNER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:415-971-2709
Mailing Address - Street 1:100 WINDING CREEK BLVD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-1883
Mailing Address - Country:US
Mailing Address - Phone:717-249-8756
Mailing Address - Fax:
Practice Address - Street 1:100 WINDING CREEK BLVD
Practice Address - Street 2:SUITE 3
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-1883
Practice Address - Country:US
Practice Address - Phone:717-249-8756
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-18
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006016101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty