Provider Demographics
NPI:1902068141
Name:DESENA, GERALDINE LOUISE (LPC, CAC)
Entity Type:Individual
Prefix:MS
First Name:GERALDINE
Middle Name:LOUISE
Last Name:DESENA
Suffix:
Gender:F
Credentials:LPC, CAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 S WALNUT LN STE 201
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009-1737
Mailing Address - Country:US
Mailing Address - Phone:724-770-9820
Mailing Address - Fax:724-371-0091
Practice Address - Street 1:300 S WALNUT LN STE 201
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-1737
Practice Address - Country:US
Practice Address - Phone:724-770-9820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC000682101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional