Organization
LANCASTER GENERAL MEDICAL GROUP
Active
Other names
Penn Medicine LGHP Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE A KENNEDY (VP FINANCIAL SERVICES)
(717) 544-5010
Entity
Organization
Contact information
Practice address
802 NEW HOLLAND AVE, LANCASTER, PA 17602-2163
(717) 560-3782
(717) 560-3787
Mailing address
802 NEW HOLLAND AVE, LANCASTER, PA 17602-2163
(717) 560-3782
(717) 560-3787
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
103T00000X
Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03092800
CAPITAL BLUE CROSS
PA
01
—
1007327490137
CBHNP
PA
01
—
1551623
GATEWAY HEALTH PLAN
PA
01
—
5702513
AETNA NON-HMO
PA
01
—
774495
HIGHMARK BLUE SHIELD
PA
01
—
817506
AETNA HMO
PA
01
—
A159896
VALUE OPTIONS
PA
01
—
CC7536
RAILROAD MEDICARE
PA
Enumeration date
11/03/2005
Last updated
11/16/2020
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