Provider Demographics
NPI:1932327145
Name:ANDERSON, JENNIFER JO (LPC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JO
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:JO
Other - Last Name:GREENHOLT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:25 BELFORD BLVD.
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:PA
Mailing Address - Zip Code:17847-9701
Mailing Address - Country:US
Mailing Address - Phone:570-522-9790
Mailing Address - Fax:570-522-0016
Practice Address - Street 1:160 ROOSEVELT AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17401-3378
Practice Address - Country:US
Practice Address - Phone:717-846-3909
Practice Address - Fax:717-846-9674
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC001113101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist