Provider Demographics
NPI:1780740092
Name:WILSON, JOANNE E (LPC)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:E
Last Name:WILSON
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 1:545 FAYETTE NESHANNOCK FALLS RD
Mailing Address - Street 2:
Mailing Address - City:VOLANT
Mailing Address - State:PA
Mailing Address - Zip Code:16156-2605
Mailing Address - Country:US
Mailing Address - Phone:724-946-9073
Mailing Address - Fax:
Practice Address - Street 1:2434 WILMINGTON RD
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-1958
Practice Address - Country:US
Practice Address - Phone:724-658-2289
Practice Address - Fax:724-658-0987
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003519101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional