Provider Demographics
NPI:1518949072
Name:HENSHELL, GERILYNN K (LCSW)
Entity Type:Individual
Prefix:
First Name:GERILYNN
Middle Name:K
Last Name:HENSHELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2215 FOREST HILLS DR
Mailing Address - Street 2:SUITE 38
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-1099
Mailing Address - Country:US
Mailing Address - Phone:717-540-5353
Mailing Address - Fax:717-540-5151
Practice Address - Street 1:2215 FOREST HILLS DR
Practice Address - Street 2:SUITE 38
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-1099
Practice Address - Country:US
Practice Address - Phone:717-540-5353
Practice Address - Fax:717-540-5151
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW001341L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA634030Medicare ID - Type UnspecifiedPROVIDER NUMBER
PAR07660Medicare UPIN