Provider Demographics
NPI:1255653291
Name:CAROTA, JENNIFER MELNICK (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:MELNICK
Last Name:CAROTA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:CLARK
Other - Last Name:MELNICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:214 CLARK ST
Mailing Address - Street 2:
Mailing Address - City:BELLE VERNON
Mailing Address - State:PA
Mailing Address - Zip Code:15012-1841
Mailing Address - Country:US
Mailing Address - Phone:412-559-1754
Mailing Address - Fax:
Practice Address - Street 1:214 CLARK ST
Practice Address - Street 2:
Practice Address - City:BELLE VERNON
Practice Address - State:PA
Practice Address - Zip Code:15012-1841
Practice Address - Country:US
Practice Address - Phone:412-559-1754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-18
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP1600X
PAPC003034101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral