Provider Demographics
NPI:1972883221
Name:STOLTZFUS, NATHAN R (LPC)
Entity Type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:R
Last Name:STOLTZFUS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:785 5TH AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:717-709-6529
Practice Address - Street 1:1886 ROHRERSTOWN RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2322
Practice Address - Country:US
Practice Address - Phone:717-735-1920
Practice Address - Fax:717-735-1921
Is Sole Proprietor?:No
Enumeration Date:2011-08-18
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005079101YP2500X
PAPC006073101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
12310171OtherCAQH
PAPC006073OtherSTATE LICENSE
PA103757376Medicaid