Provider Demographics
NPI:1750434932
Name:BUZZELL, JODI LYNN (LPC)
Entity type:Individual
Prefix:MRS
First Name:JODI
Middle Name:LYNN
Last Name:BUZZELL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1139 WOODMONT AVE
Mailing Address - Street 2:
Mailing Address - City:NEW KENSINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15068-5546
Mailing Address - Country:US
Mailing Address - Phone:724-335-5627
Mailing Address - Fax:
Practice Address - Street 1:310 CENTRAL CITY PLZ
Practice Address - Street 2:
Practice Address - City:NEW KENSINGTON
Practice Address - State:PA
Practice Address - Zip Code:15068-6441
Practice Address - Country:US
Practice Address - Phone:724-335-9883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004399101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health