Provider Demographics
NPI:1114222692
Name:SOLVINO, JENNIFER B (MA, NCC, LPC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:B
Last Name:SOLVINO
Suffix:
Gender:F
Credentials:MA, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1027 CHRISTINA DR
Mailing Address - Street 2:
Mailing Address - City:LEESPORT
Mailing Address - State:PA
Mailing Address - Zip Code:19533-8800
Mailing Address - Country:US
Mailing Address - Phone:484-332-6236
Mailing Address - Fax:
Practice Address - Street 1:1027 CHRISTINA DR
Practice Address - Street 2:
Practice Address - City:LEESPORT
Practice Address - State:PA
Practice Address - Zip Code:19533-8800
Practice Address - Country:US
Practice Address - Phone:484-332-6236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-14
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005665101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional