Provider Demographics
NPI:1205272879
Name:FREY, JOANN MARIE DAVIS (BSN, MS, LPC)
Entity type:Individual
Prefix:MS
First Name:JOANN
Middle Name:MARIE DAVIS
Last Name:FREY
Suffix:
Gender:F
Credentials:BSN, MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 SHELDON AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRCHANCE
Mailing Address - State:PA
Mailing Address - Zip Code:15436-1022
Mailing Address - Country:US
Mailing Address - Phone:724-208-2833
Mailing Address - Fax:
Practice Address - Street 1:1277 SUNCREST TOWNE CENTRE
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505
Practice Address - Country:US
Practice Address - Phone:724-309-6665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-22
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006902101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional