Provider Demographics
NPI:1538594361
Name:STAHON, JENNIFER K (LPC)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:K
Last Name:STAHON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:K
Other - Last Name:STAHON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:5006 IROQUOIS AVE
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16511-2457
Mailing Address - Country:US
Mailing Address - Phone:814-403-5588
Mailing Address - Fax:
Practice Address - Street 1:5006 IROQUOIS AVE
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16511-2457
Practice Address - Country:US
Practice Address - Phone:814-403-5588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-11
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007097101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor