Provider Demographics
NPI:1164086377
Name:MASTER, JENNIFER S (NCC, LPC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:S
Last Name:MASTER
Suffix:
Gender:F
Credentials:NCC, LPC
Other - Prefix:MRS
Other - First Name:JENNIFER
Other - Middle Name:SUSAN
Other - Last Name:MASTER-BRUNI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NCC, LPC
Mailing Address - Street 1:9 FIELDSTONE CT
Mailing Address - Street 2:
Mailing Address - City:PLUM
Mailing Address - State:PA
Mailing Address - Zip Code:15239-1074
Mailing Address - Country:US
Mailing Address - Phone:412-719-5980
Mailing Address - Fax:
Practice Address - Street 1:1501 POTOMAC AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15216-2135
Practice Address - Country:US
Practice Address - Phone:412-719-5980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-24
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC011058101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor