| Purposefully Soaring Counseling Services Llc | |
|
4755 Linglestown Rd Ste 206 Harrisburg PA 17112-8547 | |
| (717) 400-1871 | |
| (717) 814-5260 |
| Full Name | Purposefully Soaring Counseling Services Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 4755 Linglestown Rd Ste 206, Harrisburg, Pennsylvania |
| Authorized Official Name and Position | Candace Nichole Johnson (PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 7174001871 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Purposefully Soaring Counseling Services Llc 4755 Linglestown Rd Ste 206 Harrisburg PA 17112-8547 Ph: (717) 400-1871 | Purposefully Soaring Counseling Services Llc 4755 Linglestown Rd Ste 206 Harrisburg PA 17112-8547 Ph: (717) 400-1871 |
| NPI Number | 1629549928 |
|---|---|
| Provider Enumeration Date | 12/12/2018 |
| Last Update Date | 11/01/2024 |
| Certification Date | 11/01/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629549928 | NPI | - | NPPES |
| 103495049 | Medicaid | PA | |
| 3832975 | Other | PA | HIGHMARK |
| 601259189 | Other | PA | MAGELLAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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