Provider Demographics
NPI:1396260717
Name:IN HIM CHRISTIAN WELLNESS
Entity type:Organization
Organization Name:IN HIM CHRISTIAN WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR; THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:CARLTON
Authorized Official - Last Name:BURCHARD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:717-766-0935
Mailing Address - Street 1:355 N 21ST ST STE 208
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-3707
Mailing Address - Country:US
Mailing Address - Phone:717-766-0935
Mailing Address - Fax:717-510-6704
Practice Address - Street 1:355 N 21ST ST STE 208
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-3707
Practice Address - Country:US
Practice Address - Phone:717-766-0935
Practice Address - Fax:717-510-6704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC009657101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1619348299OtherNPPES