Provider Demographics
NPI:1538487228
Name:PODA-HENRY, JANELLA LYNN (LPC)
Entity Type:Individual
Prefix:
First Name:JANELLA
Middle Name:LYNN
Last Name:PODA-HENRY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:JANELLA
Other - Middle Name:LYNN
Other - Last Name:PODA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:164 OAK GROVE RD
Mailing Address - Street 2:
Mailing Address - City:PINE GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:17963-8653
Mailing Address - Country:US
Mailing Address - Phone:717-991-9306
Mailing Address - Fax:
Practice Address - Street 1:164 OAK GROVE RD
Practice Address - Street 2:
Practice Address - City:PINE GROVE
Practice Address - State:PA
Practice Address - Zip Code:17963-8653
Practice Address - Country:US
Practice Address - Phone:717-991-9306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-05
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005421101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health