Provider Demographics
NPI:1700206257
Name:SACCO, ANTOINETTE (MHS, CADC)
Entity Type:Individual
Prefix:
First Name:ANTOINETTE
Middle Name:
Last Name:SACCO
Suffix:
Gender:F
Credentials:MHS, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 WOODBERRY RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17408-5840
Mailing Address - Country:US
Mailing Address - Phone:717-792-9702
Mailing Address - Fax:717-792-9910
Practice Address - Street 1:1300 WOODBERRY RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17408-5840
Practice Address - Country:US
Practice Address - Phone:717-792-9702
Practice Address - Fax:717-792-9910
Is Sole Proprietor?:No
Enumeration Date:2014-04-23
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016277720008Medicaid
PA001627770009Medicaid