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Organization

FULTON BEHAVIORAL HEALTH SERVICES PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. ELIZABETH T. GOTWALS MSW,LCSW,ACSW,QCSW (OWNER/ADMINISTRATOR)
(717) 485-6120
Entity
Organization

Contact information

Practice address
214 PEACH ORCHARD ROAD, MC CONNELLSBURG, PA 17233
(717) 485-6120
(717) 485-6106
Mailing address
214 PEACH ORCHARD ROAD, MC CONNELLSBURG, PA 17233
(717) 485-6120
(717) 485-6106

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
104100000X
Social Worker
Primary
1041C0700X
Clinical Social Worker

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0018117730001
PA
05
1024376860001
PA
Enumeration date
09/23/2009
Last updated
08/10/2010
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