Provider Demographics
NPI:1003062571
Name:HESS, JENNIFER (PC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:HESS
Suffix:
Gender:F
Credentials:PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 W PITTSBURGH ST
Mailing Address - Street 2:
Mailing Address - City:DELMONT
Mailing Address - State:PA
Mailing Address - Zip Code:15626-1313
Mailing Address - Country:US
Mailing Address - Phone:866-472-9466
Mailing Address - Fax:800-398-6217
Practice Address - Street 1:25 HIGHLAND PARK DR
Practice Address - Street 2:SUITE 200
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-8402
Practice Address - Country:US
Practice Address - Phone:724-439-0308
Practice Address - Fax:724-439-0378
Is Sole Proprietor?:No
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
PAPCPC004854101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPCPC004854OtherSTATE LICENSE