Provider Demographics
NPI:1346571650
Name:HARRISBURG PSYCHIATRIC ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:HARRISBURG PSYCHIATRIC ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:J
Authorized Official - Last Name:LEA-STOKES
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PSYCHIATRIST
Authorized Official - Phone:717-695-3497
Mailing Address - Street 1:3544 N. PROGRESS AVE.
Mailing Address - Street 2:SUITE 108
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110
Mailing Address - Country:US
Mailing Address - Phone:717-695-3497
Mailing Address - Fax:717-695-3497
Practice Address - Street 1:3544 N. PROGRESS AVE.
Practice Address - Street 2:SUITE 108
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110
Practice Address - Country:US
Practice Address - Phone:717-695-3497
Practice Address - Fax:717-695-3497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-26
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD043845L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019686730001Medicaid
PA0019686730001Medicaid
PAB24274Medicare UPIN