Provider Demographics
NPI:1780223420
Name:HEATHERSTONE COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:HEATHERSTONE COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELINA
Authorized Official - Middle Name:
Authorized Official - Last Name:RODGERS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:717-419-9397
Mailing Address - Street 1:134 BAYBERRY DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-7002
Mailing Address - Country:US
Mailing Address - Phone:717-419-9397
Mailing Address - Fax:
Practice Address - Street 1:313 W LIBERTY ST STE 228
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-2748
Practice Address - Country:US
Practice Address - Phone:717-537-9470
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-28
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health