Provider Demographics
NPI:1831440379
Name:HERSHEY, HEIDI
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:HERSHEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:822 MARIETTA AVE
Mailing Address - Street 2:#31
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-3239
Mailing Address - Country:US
Mailing Address - Phone:717-392-7062
Mailing Address - Fax:717-392-5495
Practice Address - Street 1:822 MARIETTA AVE
Practice Address - Street 2:SUITE 31
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-3239
Practice Address - Country:US
Practice Address - Phone:717-392-7062
Practice Address - Fax:717-392-5495
Is Sole Proprietor?:No
Enumeration Date:2012-09-24
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006467101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional