Provider Demographics
NPI:1619795846
Name:HESSON, KERI (LAPC, MA)
Entity type:Individual
Prefix:
First Name:KERI
Middle Name:
Last Name:HESSON
Suffix:
Gender:F
Credentials:LAPC, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CENTER SQ STE 6
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-3012
Mailing Address - Country:US
Mailing Address - Phone:717-640-2655
Mailing Address - Fax:
Practice Address - Street 1:1 CENTER SQ STE 6
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-3012
Practice Address - Country:US
Practice Address - Phone:717-640-2655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-27
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAPC000342101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health