Provider Demographics
NPI:1922012798
Name:BEAR, WAYNE R (LSW)
Entity Type:Individual
Prefix:MR
First Name:WAYNE
Middle Name:R
Last Name:BEAR
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 STILLCREEK LANE
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17406
Mailing Address - Country:US
Mailing Address - Phone:717-755-0419
Mailing Address - Fax:717-757-1353
Practice Address - Street 1:3995 EAST MARKET ST.
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17406
Practice Address - Country:US
Practice Address - Phone:717-755-0419
Practice Address - Fax:717-757-1353
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW010372L104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker