Provider Demographics
NPI:1407052798
Name:HIVELY, CHARLES PAUL
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:PAUL
Last Name:HIVELY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:965 MILLCREEK RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17404-9606
Mailing Address - Country:US
Mailing Address - Phone:717-764-2164
Mailing Address - Fax:
Practice Address - Street 1:63360 NW BRITTA ST
Practice Address - Street 2:BUILDING 1
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-6869
Practice Address - Country:US
Practice Address - Phone:541-318-4845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health