Provider Demographics
NPI:1740679687
Name:YUNGINGER, NADINE (LSW)
Entity type:Individual
Prefix:
First Name:NADINE
Middle Name:
Last Name:YUNGINGER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:NADINE
Other - Middle Name:
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:709 MAIN ST APT A
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:PA
Mailing Address - Zip Code:17501-1318
Mailing Address - Country:US
Mailing Address - Phone:717-940-6198
Mailing Address - Fax:
Practice Address - Street 1:709 MAIN ST APT A
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:PA
Practice Address - Zip Code:17501-1318
Practice Address - Country:US
Practice Address - Phone:717-940-6198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-15
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW132103104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker