Elisabeth T Clark, | |
108 S Main St, Manheim, PA 17545-1602 | |
(717) 665-2675 | |
Not Available |
Full Name | Elisabeth T Clark |
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Gender | Female |
Speciality | Counselor - Professional |
Location | 108 S Main St, Manheim, Pennsylvania |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1184188039 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | PC001265 (Pennsylvania) | Primary |
Entity Name | Psychological Health Affiliates Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1740201920 PECOS PAC ID: 5698781672 Enrollment ID: O20060228000656 |
Mailing Address | Practice Location Address |
---|---|
Elisabeth T Clark, 14 Bourbon Red Dr, Mechanicsburg, PA 17050-7902 Ph: (717) 903-1432 | Elisabeth T Clark, 108 S Main St, Manheim, PA 17545-1602 Ph: (717) 665-2675 |
Megan Fulmer, LPC Counselor Medicare: Medicare Enrolled Practice Location: 108 S Main St, Manheim, PA 17545 Phone: 717-665-2675 | |
Jolene Grove Ness, MS, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 108 S Main St, Manheim, PA 17545 Phone: -- | |
Mrs. Kelly Smith, Counselor Medicare: Not Enrolled in Medicare Practice Location: 618 Hamaker Rd, Manheim, PA 17545 Phone: 717-519-9740 | |
Mrs. Nicole Marie Pfaff, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 112 S Main Street, Suite C, Manheim, PA 17545 Phone: 484-477-8223 | |
Michael L Martin, REVEREND Counselor Medicare: Not Enrolled in Medicare Practice Location: 1340 Newport Rd, Manheim, PA 17545 Phone: 717-824-5965 | |
Ms. Kimberly Ann Winters, Counselor Medicare: Medicare Enrolled Practice Location: 108 S Main St, Manheim, PA 17545 Phone: 717-665-2675 Fax: 717-665-6193 |