Provider Demographics
NPI:1780724864
Name:MOLCHANY, JACOB PETER (MED, NCC, LPC)
Entity type:Individual
Prefix:MR
First Name:JACOB
Middle Name:PETER
Last Name:MOLCHANY
Suffix:
Gender:M
Credentials:MED, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5543 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:PA
Mailing Address - Zip Code:18052-1705
Mailing Address - Country:US
Mailing Address - Phone:484-554-3040
Mailing Address - Fax:
Practice Address - Street 1:5543 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:PA
Practice Address - Zip Code:18052-1705
Practice Address - Country:US
Practice Address - Phone:484-554-3040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC002072101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional