Provider Demographics
NPI:1740370014
Name:JEANNERAT, NANCY JANE (MA, LPC, CAC)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:JANE
Last Name:JEANNERAT
Suffix:
Gender:F
Credentials:MA, LPC, CAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:CLARION
Mailing Address - State:PA
Mailing Address - Zip Code:16214-1829
Mailing Address - Country:US
Mailing Address - Phone:814-226-8669
Mailing Address - Fax:814-226-5329
Practice Address - Street 1:240 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:CLARION
Practice Address - State:PA
Practice Address - Zip Code:16214-1829
Practice Address - Country:US
Practice Address - Phone:814-226-8669
Practice Address - Fax:814-226-5329
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC002969101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional