Provider Demographics
NPI:1407047335
Name:CAPITAL AREA COUNSELING SERVICES, INC.
Entity Type:Organization
Organization Name:CAPITAL AREA COUNSELING SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:PATTON
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:717-975-1808
Mailing Address - Street 1:1013 MUMMA RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:WORMLEYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17043-1144
Mailing Address - Country:US
Mailing Address - Phone:717-975-1808
Mailing Address - Fax:
Practice Address - Street 1:1013 MUMMA RD
Practice Address - Street 2:SUITE 302
Practice Address - City:WORMLEYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17043-1144
Practice Address - Country:US
Practice Address - Phone:717-975-1808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW014019251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health