Individual provider Active NPI

Hana Longenecker, PSYD

  • Clinical Child & Adolescent Psychologist
  • Lebanon, PA
National Provider Identifier
1407404874
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
PS019388 Issued in PA
Practice address
964 Isabel Dr
Lebanon, PA 17042-7482
Phone
(717) 274-9777
NPI assigned
Aug 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Child & Adolescent Psychologist 103TC2200X
Clinical Child & Adolescent Psychologist 103TC2200X PS019388 PA Primary

Addresses

Primary practice location

964 Isabel Dr
Lebanon, PA 17042-7482

Mailing address

785 5TH Ave Ste 3
Chambersburg, PA 17201-4232
Phone (717) 263-9555

Other identifiers 1

IdentifierTypeStateIssuer
104024531MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220318000475 PA Practitioner - Clinical Psychologist 3375938913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
PhilhavenGroup PAC ID 8729991419, 93 clinicians

Practice addresses (Care Compare)

2501 Oregon Pike
Lancaster, PA 17601-4890
Phone (717) 735-1954

964 Isabel Dr
Lebanon, PA 17042-7482
Phone (717) 274-9777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PS019388PAMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Philhaven CurrentSince Dec 17, 2021 Accepting new patients
Philhaven CurrentSince Dec 17, 2021 Accepting new patients
Wellspan Medical Group PastSince Apr 1, 2022 Accepting new patients

Locations

785 5th Ave
Ste 3
Chambersburg, PA 17201

2501 Oregon Pike
Ste 113
Lancaster, PA 17601
Phone (717) 735-1954

964 Isabel Dr
Lebanon, PA 17042
Phone (717) 274-9777

204 Hathaway Park
Lebanon, PA 17042
Phone (717) 274-9777

283 Butler Rd
Mount Gretna, PA 17064
Phone (800) 932-0359

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1567036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680134400000",
    "number": "1407404874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "785 5TH AVE STE 3",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172014232",
            "telephone_number": "717-263-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "964 ISABEL DR",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170427482",
            "telephone_number": "717-274-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGENECKER",
        "first_name": "HANA",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-29",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "PA",
            "license": "PS019388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104024531",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, PA

Sources for this page

Verify at the official NPI Registry.