Provider Demographics
NPI:1710029319
Name:ERNST, JEFFREY DEAN (MA)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:DEAN
Last Name:ERNST
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 LONGVIEW RD
Mailing Address - Street 2:
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-8120
Mailing Address - Country:US
Mailing Address - Phone:610-361-8362
Mailing Address - Fax:302-368-5309
Practice Address - Street 1:8 POLLY DRUMMOND HILL RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-5703
Practice Address - Country:US
Practice Address - Phone:302-738-6859
Practice Address - Fax:302-368-5309
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral