Provider Demographics
NPI:1225792583
Name:EDWARD JENNY & ASSOCIATES PC
Entity Type:Organization
Organization Name:EDWARD JENNY & ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:JENNY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:610-444-6089
Mailing Address - Street 1:127 W STREET RD STE 302
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-1698
Mailing Address - Country:US
Mailing Address - Phone:610-444-6089
Mailing Address - Fax:833-471-3277
Practice Address - Street 1:127 W STREET RD STE 302
Practice Address - Street 2:
Practice Address - City:KENNETT SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19348-1698
Practice Address - Country:US
Practice Address - Phone:610-444-6089
Practice Address - Fax:833-471-3277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-23
Last Update Date:2021-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty