Provider Demographics
NPI:1578928727
Name:BROSENITSCH, JENNIFER LORRAINE (LPC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LORRAINE
Last Name:BROSENITSCH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:STOLTZFUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:350 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-4921
Mailing Address - Country:US
Mailing Address - Phone:724-287-5604
Mailing Address - Fax:724-287-3779
Practice Address - Street 1:101 OAK RIDGE DR STE E
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16002
Practice Address - Country:US
Practice Address - Phone:724-453-4595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-15
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC008606101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional