Provider Demographics
NPI:1164586012
Name:MCCRACKEN, JANET ELLEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:ELLEN
Last Name:MCCRACKEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 W FOSTER AVE
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-4823
Mailing Address - Country:US
Mailing Address - Phone:814-238-1880
Mailing Address - Fax:814-867-2794
Practice Address - Street 1:229 W FOSTER AVE
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-4823
Practice Address - Country:US
Practice Address - Phone:814-238-1880
Practice Address - Fax:814-867-2794
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS008484L103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling