Provider Demographics
NPI:1740931971
Name:PANATIERI, GENA (LCSW)
Entity type:Individual
Prefix:
First Name:GENA
Middle Name:
Last Name:PANATIERI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:299 LYNDWOOD AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:HANOVER TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18706-1300
Mailing Address - Country:US
Mailing Address - Phone:157-079-0969
Mailing Address - Fax:
Practice Address - Street 1:299 LYNDWOOD AVE APT 4
Practice Address - Street 2:
Practice Address - City:HANOVER TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18706-1300
Practice Address - Country:US
Practice Address - Phone:570-790-9699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-10
Last Update Date:2023-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1080861041C0700X
PACW0224121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical