Provider Demographics
NPI:1063716801
Name:PSYCHOTHERAPY ASSOCIATES OF LANCASTER COUNTY, PC
Entity type:Organization
Organization Name:PSYCHOTHERAPY ASSOCIATES OF LANCASTER COUNTY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:KNAUB
Authorized Official - Suffix:
Authorized Official - Credentials:MSED
Authorized Official - Phone:402-475-5069
Mailing Address - Street 1:1919 S 40TH ST
Mailing Address - Street 2:SUITE 312
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-5243
Mailing Address - Country:US
Mailing Address - Phone:402-745-5069
Mailing Address - Fax:402-475-2350
Practice Address - Street 1:1919 S 40TH ST
Practice Address - Street 2:SUITE 312
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-5243
Practice Address - Country:US
Practice Address - Phone:402-745-5069
Practice Address - Fax:402-475-2350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-10
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty