Provider Demographics
NPI:1306249909
Name:NEW STORY
Entity type:Organization
Organization Name:NEW STORY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KARA
Authorized Official - Middle Name:
Authorized Official - Last Name:KESSEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-901-9906
Mailing Address - Street 1:2700 COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110-9365
Mailing Address - Country:US
Mailing Address - Phone:717-901-9906
Mailing Address - Fax:
Practice Address - Street 1:6818 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17111-4444
Practice Address - Country:US
Practice Address - Phone:717-439-9807
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-27
Last Update Date:2014-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH002101251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA12700711Medicaid