Provider Demographics
NPI:1184934556
Name:HACKMAN, DENISE (LPC)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:HACKMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:
Other - Last Name:POREMBA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2215 FOREST HILLS DR STE 36
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-1099
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2215 FOREST HILLS DR STE 36
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-1099
Practice Address - Country:US
Practice Address - Phone:717-775-8078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-19
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA8946101YA0400X
PAPC008586101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPC008586OtherLICENSE