Provider Demographics
NPI:1326128000
Name:HORSTMAN, THERESA M (LCSW)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:M
Last Name:HORSTMAN
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 1:10 SNYDER RD
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-3432
Mailing Address - Country:US
Mailing Address - Phone:724-981-2773
Mailing Address - Fax:
Practice Address - Street 1:10 SNYDER RD
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-3432
Practice Address - Country:US
Practice Address - Phone:724-981-2773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0141011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA336643OtherVALUE OPTIONS
PA552127OtherBCBS SEC65 SPECIAL SE
PA0011099910001OtherDPW
PA0489834OtherAETNA
202179OtherUPMC POS HMO
25163861200OtherCOGNA
PA0489834OtherAETNA HMO MEDICARE
845744OtherKHPW HMO
OH0789384OtherDPW
336643OtherVALUE OPTIONS VA
000000115000OtherONE NATION BENEFIT ADMIN
251638612OtherMEDICAL MUT PPO
PA845744OtherBCBS
PAE52896OtherHEALTH ASSURANCE
NY336643OtherVALUE OPTIONS
215580000OtherMAGELLAN BEHAVIORAL
PA845744OtherBCBS PPO POS HMO TRAD
PA0011099910001OtherDPW
800008123Medicare ID - Type UnspecifiedRAILROAD