Provider Demographics
NPI:1790867083
Name:CHARNEY, JASON L (LPC)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:L
Last Name:CHARNEY
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:196 36TH ST APT 3H
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15201-1356
Mailing Address - Country:US
Mailing Address - Phone:412-447-8630
Mailing Address - Fax:
Practice Address - Street 1:239 4TH AVE
Practice Address - Street 2:SUITE 1618
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15222-1706
Practice Address - Country:US
Practice Address - Phone:412-447-8630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003965101YM0800X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001786464OtherHIGHMARK ID