Provider Demographics
NPI:1700454535
Name:BAHLOW, BROOKLYN (LCSW)
Entity Type:Individual
Prefix:
First Name:BROOKLYN
Middle Name:
Last Name:BAHLOW
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 N SUSQUEHANNA TRAIL
Mailing Address - Street 2:SUITE A
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17404-9602
Mailing Address - Country:US
Mailing Address - Phone:717-524-6681
Mailing Address - Fax:
Practice Address - Street 1:205 S FRONT ST FL 5
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17104-1619
Practice Address - Country:US
Practice Address - Phone:717-231-8360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-17
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0239461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical