Provider Demographics
NPI:1013056407
Name:LENSBOWER, JEFFREY LYNN (MS, FCICPP)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:LYNN
Last Name:LENSBOWER
Suffix:
Gender:M
Credentials:MS, FCICPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1970 SCOTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-1450
Mailing Address - Country:US
Mailing Address - Phone:717-263-6370
Mailing Address - Fax:717-263-9579
Practice Address - Street 1:1970 SCOTLAND AVE
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-1450
Practice Address - Country:US
Practice Address - Phone:717-263-6370
Practice Address - Fax:717-263-9579
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS006274L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012960070001Medicaid
PALE172614OtherBLUECROSS BLUESHIELD