Provider Demographics
NPI:1275985194
Name:RECTOR, ALAYSHA MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:ALAYSHA
Middle Name:MARIE
Last Name:RECTOR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5258 WYNNEWOOD RD
Mailing Address - Street 2:APT B
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-5486
Mailing Address - Country:US
Mailing Address - Phone:717-343-9775
Mailing Address - Fax:
Practice Address - Street 1:5258 WYNNEWOOD RD
Practice Address - Street 2:APT B
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-5486
Practice Address - Country:US
Practice Address - Phone:717-343-9775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-02
Last Update Date:2016-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0190441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical