Provider Demographics
NPI:1538591870
Name:BANEY, JENNIFER
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:BANEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 YORK ST STE F
Mailing Address - Street 2:
Mailing Address - City:GETTYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17325-1937
Mailing Address - Country:US
Mailing Address - Phone:717-727-2627
Mailing Address - Fax:717-323-1211
Practice Address - Street 1:304 YORK ST STE F
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-1937
Practice Address - Country:US
Practice Address - Phone:717-727-2627
Practice Address - Fax:717-323-1211
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-08
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC009603101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health