1700139581 NPI number — JOANNE HALL LONGENECKER M.ED.

Table of content: JOANNE HALL LONGENECKER M.ED. (NPI 1700139581)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700139581 NPI number — JOANNE HALL LONGENECKER M.ED.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LONGENECKER
Provider First Name:
JOANNE
Provider Middle Name:
HALL
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.ED.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LONGENECKER
Provider Other First Name:
JOANNE
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.ED.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1700139581
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/18/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
621 MAPLEWOOD AVE.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOHNTON
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19540-1522
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-775-4309
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
400 WASHINGTON ST
Provider Second Line Business Practice Location Address:
CATHOLIC CHARITIES, 1ST FLOOR
Provider Business Practice Location Address City Name:
READING
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19601-3915
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-376-7144
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/18/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  PC004298 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)