Provider Demographics
NPI:1326215963
Name:AUSTAD, JENNIFER HOPE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:HOPE
Last Name:AUSTAD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 ALWINE AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-3209
Mailing Address - Country:US
Mailing Address - Phone:724-396-2862
Mailing Address - Fax:724-836-6197
Practice Address - Street 1:113 ALWINE AVE
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-3209
Practice Address - Country:US
Practice Address - Phone:724-396-2862
Practice Address - Fax:724-836-6197
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-13
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW124552104100000X, 1041C0700X, 1041S0200X
PACW015870104100000X, 1041C0700X, 1041S0200X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health