Provider Demographics
NPI:1295340859
Name:FAUST, KEVIN LEE (MS, LPC, NCC)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:LEE
Last Name:FAUST
Suffix:
Gender:M
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 PAUL AVE
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-3772
Mailing Address - Country:US
Mailing Address - Phone:717-552-4180
Mailing Address - Fax:
Practice Address - Street 1:47 W POMFRET ST
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-3217
Practice Address - Country:US
Practice Address - Phone:717-258-0214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-10
Last Update Date:2021-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC012652101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty