Provider Demographics
NPI:1467662130
Name:BLANC COUNSELING SERVICES
Entity Type:Organization
Organization Name:BLANC COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER & THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:BLANC
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:717-303-5960
Mailing Address - Street 1:1017 MUMMA ROAD
Mailing Address - Street 2:SUIT 200
Mailing Address - City:WORMLEYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17043
Mailing Address - Country:US
Mailing Address - Phone:717-303-5960
Mailing Address - Fax:717-303-5962
Practice Address - Street 1:1017 MUMMA ROAD
Practice Address - Street 2:SUIT 200
Practice Address - City:WORMLEYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17043
Practice Address - Country:US
Practice Address - Phone:717-303-5960
Practice Address - Fax:717-303-5962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC002092101Y00000X, 101YA0400X, 101YM0800X, 101YP2500X, 106H00000X
PAPC00202092101Y00000X
PAPC005503101YP2500X
PAPC002632104100000X, 1041C0700X
PACW0163271041C0700X
PARN305048L251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No251J00000XAgenciesNursing CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1962521021OtherNPI
PA1497981609OtherNPI
PA1245313360OtherVIVIAN BLANC NPI