Provider Demographics
NPI:1437252517
Name:COMMUNITY COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:COMMUNITY COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DEWANA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:MHS LPC CAC CCJP
Authorized Official - Phone:717-845-2425
Mailing Address - Street 1:PO BOX 7726
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17404-0726
Mailing Address - Country:US
Mailing Address - Phone:717-845-2425
Mailing Address - Fax:717-845-2682
Practice Address - Street 1:239 W PHILADELPHIA ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17401
Practice Address - Country:US
Practice Address - Phone:717-845-2425
Practice Address - Fax:717-845-2682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007140200OtherAETNA
PA004415OtherVALUE OPTIONS
PA1009989660002Medicaid
PA1201648OtherAETNA
PA1376652487OtherUNITED BEHAVIORAL HEALTH
PA171061000OtherMAGELLAN
PA50042879OtherBLUE CROSS
PA001636224OtherBLUE SHIELD
PA1504909OtherGATEWAY HEALTH PLAN
PA2009773000OtherMAGELLAN
PA1073576278OtherUNITED BEHAVIORAL HEALTH
PA0007120286OtherAETNA
PA1567799OtherGATEWAY HEALTH PLAN
PA10009989660001Medicaid
PA1073576278OtherUNITED BEHAVIORAL HEALTH
PA1009989660002Medicaid