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Contact Information

LIFE SPAN PSYCHOLOGICAL SERVICES PC
28190 WILLOW ST PK
WILLOW STREET, PA17584
 Phone: 717-464-1464
 Fax: 717-464-4348
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
 

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Professional

101YP2500X
 

Social Worker

104100000X
Indicates primary specialty

NPI Profile & details for LIFE SPAN PSYCHOLOGICAL SERVICES PC

NPI Number 1912958356
LBN Legal business name LIFE SPAN PSYCHOLOGICAL SERVICES PC
Authorized official LYNNETTE RUCH - (PHD)
Entity Organization
Organization subpart 1 No
Enumeration date 05/12/2006
Last updated 09/11/2025 - About 9 months ago
Identifiers
PA License # PC002382
PA License # PS006874L
PA License # SW011339L
PA License # SW123210L
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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