Provider Demographics
NPI:1376186478
Name:LOPATKA, JENNA
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:LOPATKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 PITTSTON AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18505-1150
Mailing Address - Country:US
Mailing Address - Phone:570-342-5444
Mailing Address - Fax:
Practice Address - Street 1:101 PITTSTON AVE STE 3
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18505-1150
Practice Address - Country:US
Practice Address - Phone:570-342-5444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-21
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker