Provider Demographics
NPI:1962812719
Name:NEARY, KATIE (MS)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:NEARY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 STONY RUN WAY
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17406-6108
Mailing Address - Country:US
Mailing Address - Phone:717-273-5992
Mailing Address - Fax:
Practice Address - Street 1:15 S 9TH ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-5104
Practice Address - Country:US
Practice Address - Phone:717-273-5992
Practice Address - Fax:717-273-5995
Is Sole Proprietor?:No
Enumeration Date:2014-05-02
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH001677101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health