Provider Demographics
NPI:1386830529
Name:JENNINGS, AARON (LCSW)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:
Last Name:JENNINGS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2540 MONROEVILLE BLVD
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146
Mailing Address - Country:US
Mailing Address - Phone:412-823-5155
Mailing Address - Fax:412-823-8262
Practice Address - Street 1:2540 MONROEVILLE BLVD
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2329
Practice Address - Country:US
Practice Address - Phone:412-823-5155
Practice Address - Fax:412-823-8262
Is Sole Proprietor?:No
Enumeration Date:2007-09-21
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW14868101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001667664OtherBC/BS