Provider Demographics
NPI:1740382191
Name:BARCH, JENNIFER L (ACS, NCC, LPC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:L
Last Name:BARCH
Suffix:
Gender:F
Credentials:ACS, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:497 STANDARD AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:PA
Mailing Address - Zip Code:15144-1430
Mailing Address - Country:US
Mailing Address - Phone:412-720-6404
Mailing Address - Fax:
Practice Address - Street 1:717 12TH ST
Practice Address - Street 2:
Practice Address - City:BEAVER FALLS
Practice Address - State:PA
Practice Address - Zip Code:15010-4479
Practice Address - Country:US
Practice Address - Phone:412-720-6404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA001354101YP2500X
PAPC001354101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA110565Medicare UPIN