Provider Demographics
NPI:1548583024
Name:TRAUMA COUNSELING CENTERS, LLC
Entity Type:Organization
Organization Name:TRAUMA COUNSELING CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHILD & ADOLESCENT COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:L
Authorized Official - Last Name:DUCKWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC, CTS
Authorized Official - Phone:717-337-9888
Mailing Address - Street 1:450 W MIDDLE ST
Mailing Address - Street 2:
Mailing Address - City:GETTYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17325-2443
Mailing Address - Country:US
Mailing Address - Phone:717-337-9888
Mailing Address - Fax:
Practice Address - Street 1:450 W MIDDLE ST
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-2443
Practice Address - Country:US
Practice Address - Phone:717-337-9888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-11
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005417251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health