Provider Demographics
NPI:1992455992
Name:PETERS, CECILIA B (MA)
Entity type:Individual
Prefix:
First Name:CECILIA
Middle Name:B
Last Name:PETERS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4076 MARKET ST STE 100
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-4200
Mailing Address - Country:US
Mailing Address - Phone:717-918-4900
Mailing Address - Fax:866-241-2670
Practice Address - Street 1:4076 MARKET ST STE 100
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-4200
Practice Address - Country:US
Practice Address - Phone:717-918-4900
Practice Address - Fax:866-241-2670
Is Sole Proprietor?:No
Enumeration Date:2022-03-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health