Provider Demographics
NPI:1427246495
Name:PENTZ, MARK CAMERON (LPC, CACD, CHT, NLP)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:CAMERON
Last Name:PENTZ
Suffix:
Gender:M
Credentials:LPC, CACD, CHT, NLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 E KING ST
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-2171
Mailing Address - Country:US
Mailing Address - Phone:717-843-4357
Mailing Address - Fax:717-854-0000
Practice Address - Street 1:220 E KING ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-2171
Practice Address - Country:US
Practice Address - Phone:717-843-4357
Practice Address - Fax:717-854-0000
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-04
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA4796101YA0400X
PAPC003453101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)