Provider Demographics
NPI:1659570828
Name:SOMMER, JEAN LOUISE
Entity Type:Individual
Prefix:MRS
First Name:JEAN
Middle Name:LOUISE
Last Name:SOMMER
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:JEAN
Other - Middle Name:LOUISE
Other - Last Name:SHARKAZY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:2622 CRYSTAL DR
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:PA
Mailing Address - Zip Code:18052-3830
Mailing Address - Country:US
Mailing Address - Phone:610-439-0646
Mailing Address - Fax:
Practice Address - Street 1:2341 WALBERT AVE
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-1351
Practice Address - Country:US
Practice Address - Phone:610-434-2431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004198101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional