Provider Demographics
NPI:1497068340
Name:SANTORA, JESSICA W (LPC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:W
Last Name:SANTORA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 PHOENIX DR
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4537
Mailing Address - Country:US
Mailing Address - Phone:717-261-9833
Mailing Address - Fax:717-261-9832
Practice Address - Street 1:426 PHOENIX DR
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-4537
Practice Address - Country:US
Practice Address - Phone:717-261-9833
Practice Address - Fax:717-261-9832
Is Sole Proprietor?:No
Enumeration Date:2010-07-21
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005550101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional