Provider Demographics
NPI:1215424650
Name:HEART WORK & PLAY, LLC
Entity type:Organization
Organization Name:HEART WORK & PLAY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOLE MEMBER-CLINICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:A
Authorized Official - Last Name:DOUBRAVA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD LPC
Authorized Official - Phone:717-379-2284
Mailing Address - Street 1:129 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:GLEN ROCK
Mailing Address - State:PA
Mailing Address - Zip Code:17327-1103
Mailing Address - Country:US
Mailing Address - Phone:717-379-2284
Mailing Address - Fax:
Practice Address - Street 1:50 MOUNT ZION RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-2635
Practice Address - Country:US
Practice Address - Phone:717-379-2284
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-20
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1952332900OtherNPI