Provider Demographics
NPI:1215265418
Name:ITS A PLAYFUL JOURNEY
Entity type:Organization
Organization Name:ITS A PLAYFUL JOURNEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHILD, ADOLESCENT, FAMILY THERAPIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:MATHIAS
Authorized Official - Suffix:
Authorized Official - Credentials:MHS, LPC, RPT-S
Authorized Official - Phone:717-431-2027
Mailing Address - Street 1:2173 EMBASSY DR
Mailing Address - Street 2:SUITE 255
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-2387
Mailing Address - Country:US
Mailing Address - Phone:717-431-2027
Mailing Address - Fax:717-431-2014
Practice Address - Street 1:2173 EMBASSY DR
Practice Address - Street 2:SUITE 255
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-2387
Practice Address - Country:US
Practice Address - Phone:717-431-2027
Practice Address - Fax:717-431-2014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-27
Last Update Date:2009-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1740305218OtherHEALTH ASSURANCE
PA1740305218OtherEDUCATORS HEALTH PARTNERS
PA1740305218OtherQUEST BEHAVIORAL HEALTH
PA1740305218OtherCAPITAL BLUE CROSS