Provider Demographics
NPI:1659540094
Name:HOOVER, MARY JEANNE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MARY JEANNE
Middle Name:
Last Name:HOOVER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10475 PERRY HWY
Mailing Address - Street 2:TOWNCENTER, STE 300
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9274
Mailing Address - Country:US
Mailing Address - Phone:724-759-7500
Mailing Address - Fax:724-759-7600
Practice Address - Street 1:10475 PERRY HWY
Practice Address - Street 2:TOWNCENTER, STE 300
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9274
Practice Address - Country:US
Practice Address - Phone:724-759-7500
Practice Address - Fax:724-759-7600
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-28
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0158921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical