Provider Demographics
NPI:1386298404
Name:PURPOSEFULLY SOARING COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:PURPOSEFULLY SOARING COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LSW
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:L
Authorized Official - Last Name:FORESTAL-GIBSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-400-1871
Mailing Address - Street 1:4512 BOLTON NOTCH PL
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110-3414
Mailing Address - Country:US
Mailing Address - Phone:717-400-1871
Mailing Address - Fax:717-814-5260
Practice Address - Street 1:4755 LINGLESTOWN RD STE 206
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-8547
Practice Address - Country:US
Practice Address - Phone:717-400-1871
Practice Address - Fax:717-814-5260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-26
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty