Provider Demographics
NPI:1740201920
Name:PSYCHOLOGICAL HEALTH AFFILIATES LLC
Entity Type:Organization
Organization Name:PSYCHOLOGICAL HEALTH AFFILIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:ROSEMARY
Authorized Official - Last Name:HOSTLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-665-2675
Mailing Address - Street 1:934 E CHOCOLATE AVE
Mailing Address - Street 2:
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-1215
Mailing Address - Country:US
Mailing Address - Phone:717-665-2675
Mailing Address - Fax:717-256-0599
Practice Address - Street 1:934 E CHOCOLATE AVE
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-1215
Practice Address - Country:US
Practice Address - Phone:717-665-2675
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty