Provider Demographics
NPI:1780009241
Name:DEPANICIS, JENNIFER NICOLE
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:NICOLE
Last Name:DEPANICIS
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:JENNIFER
Other - Middle Name:NICOLE
Other - Last Name:LEARN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:777 PENN CENTER BLVD
Mailing Address - Street 2:BUILDING #7, SUITE 200
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15235-5927
Mailing Address - Country:US
Mailing Address - Phone:412-731-9707
Mailing Address - Fax:412-731-9834
Practice Address - Street 1:777 PENN CENTER BLVD
Practice Address - Street 2:BUILDING #7, SUITE 200
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15235-5927
Practice Address - Country:US
Practice Address - Phone:412-731-9707
Practice Address - Fax:412-731-9834
Is Sole Proprietor?:No
Enumeration Date:2014-02-20
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health