Provider Demographics
NPI:1396213641
Name:LONGENECKER, DAENA LYNN (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:DAENA
Middle Name:LYNN
Last Name:LONGENECKER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 EAST MAIN STREET
Mailing Address - Street 2:PO BOX 357
Mailing Address - City:MT. JOY
Mailing Address - State:PA
Mailing Address - Zip Code:17552
Mailing Address - Country:US
Mailing Address - Phone:717-413-9594
Mailing Address - Fax:
Practice Address - Street 1:83 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT JOY
Practice Address - State:PA
Practice Address - Zip Code:17552-1424
Practice Address - Country:US
Practice Address - Phone:717-413-9594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-05
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000895106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist