Provider Demographics
NPI:1376825125
Name:PIERGIOVANNI, DANA RENEE (MA, LPC, BCBA)
Entity type:Individual
Prefix:MS
First Name:DANA
Middle Name:RENEE
Last Name:PIERGIOVANNI
Suffix:
Gender:F
Credentials:MA, LPC, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:PA
Mailing Address - Zip Code:19405-1726
Mailing Address - Country:US
Mailing Address - Phone:610-213-4073
Mailing Address - Fax:
Practice Address - Street 1:225 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:PA
Practice Address - Zip Code:19405-1726
Practice Address - Country:US
Practice Address - Phone:610-213-4073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-16
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005623101YM0800X
PA1-10-7684103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst