Provider Demographics
NPI:1699195040
Name:JOANNE PANTANELLA, LCSW, LLC
Entity Type:Organization
Organization Name:JOANNE PANTANELLA, LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:PANTANELLA-CRUMLING
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:717-519-8882
Mailing Address - Street 1:1899 LITITZ PIKE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-6518
Mailing Address - Country:US
Mailing Address - Phone:717-519-8882
Mailing Address - Fax:717-519-8887
Practice Address - Street 1:1899 LITITZ PIKE
Practice Address - Street 2:SUITE 7
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-6518
Practice Address - Country:US
Practice Address - Phone:717-519-8882
Practice Address - Fax:717-519-8887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-24
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW015470251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health