Provider Demographics
NPI:1922693852
Name:HASSENBEIN, KENNETH DAVID JR (MS, LPC)
Entity Type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:DAVID
Last Name:HASSENBEIN
Suffix:JR
Gender:M
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 LAYTON RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH ABINGTON TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18411-9311
Mailing Address - Country:US
Mailing Address - Phone:570-621-8447
Mailing Address - Fax:
Practice Address - Street 1:820 LAYTON RD
Practice Address - Street 2:
Practice Address - City:SOUTH ABINGTON TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18411-9311
Practice Address - Country:US
Practice Address - Phone:570-621-8447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010636101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional