Provider Demographics
NPI:1700139581
Name:LONGENECKER, JOANNE HALL (MED)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:HALL
Last Name:LONGENECKER
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:JOANNE
Other - Middle Name:ELIZABETH
Other - Last Name:LONGENECKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MED
Mailing Address - Street 1:621 MAPLEWOOD AVE.
Mailing Address - Street 2:
Mailing Address - City:MOHNTON
Mailing Address - State:PA
Mailing Address - Zip Code:19540-1522
Mailing Address - Country:US
Mailing Address - Phone:610-775-4309
Mailing Address - Fax:
Practice Address - Street 1:400 WASHINGTON ST
Practice Address - Street 2:CATHOLIC CHARITIES, 1ST FLOOR
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19601-3915
Practice Address - Country:US
Practice Address - Phone:610-376-7144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004298101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional