Provider Demographics
NPI:1134648769
Name:AUGUST, JENNIE NICHOLE (ATR-BC, LPC)
Entity Type:Individual
Prefix:
First Name:JENNIE
Middle Name:NICHOLE
Last Name:AUGUST
Suffix:
Gender:F
Credentials:ATR-BC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 FORT COUCH RD STE 2
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15241-1030
Mailing Address - Country:US
Mailing Address - Phone:412-831-1223
Mailing Address - Fax:412-831-1034
Practice Address - Street 1:110 FORT COUCH RD STE 2
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241-1030
Practice Address - Country:US
Practice Address - Phone:412-831-1223
Practice Address - Fax:412-831-1034
Is Sole Proprietor?:No
Enumeration Date:2017-09-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC009863101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional