NPIMap

Organization Active NPI

Pac Center of Healing and Wellness, LLC

  • Professional Counselor
  • York, PA
National Provider Identifier
1104475953
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
PAC CENTER OF HEALING AND WELLNESS, LLC
Practice address
4150 W Market St
York, PA 17408-5934
Phone
(717) 650-6583
Fax
(717) 793-2165
NPI assigned
Sep 4, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kim Jane Sanders, MA, LPC
Title
President/Therapist
Phone
(717) 650-6583

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X

Addresses

Primary practice location

4150 W Market St
York, PA 17408-5934

Mailing address

4150 W Market St
York, PA 17408-5934
Phone (717) 650-6583

Other names 2

  • PAC Center of Healing and Wellness, LLC Doing business as
  • Uplifted Counseling Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240104000206 PA Part B Supplier - Clinic/Group Practice 8729439765 Receives reassigned benefits from 1 practitioner
Practice locations: York, PA

National Provider Directory

National Provider Directory

Locations

3301 W Market St
York, PA 17404
Phone (717) 775-3380

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1567555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736726400000",
    "number": "1104475953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 W MARKET ST",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174085934",
            "telephone_number": "717-650-6583",
            "fax_number": "717-793-2165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 W MARKET ST",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174085934",
            "telephone_number": "717-650-6583",
            "fax_number": "717-793-2165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAC CENTER OF HEALING AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-04",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "PRESIDENT/THERAPIST",
        "authorized_official_telephone_number": "717-650-6583",
        "authorized_official_credential": "MA, LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PAC Center of Healing and Wellness, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PAC Center of Healing and Wellness, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Uplifted Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in York, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.