Jodi Lynn Desimone, M.S.
Individual provider Active NPI Counselor · Strafford, PA
NPI 1609166297 · NPPES record last updated Apr 15, 2011
Key facts
- NPI
- 1609166297
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 26142913 (PA)
- Practice address
- 85 Old Eagle School Rd
Suite 200-Second Floor
Strafford, PA 19087-2556 - Phone
- (610) 688-1636
- NPI assigned
- Apr 15, 2011
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26142913 | PA | MD | Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 26142913 | PA | Yes |
Addresses
Primary practice location
85 Old Eagle School Rd
Suite 200-Second Floor
Strafford, PA 19087-2556
Mailing address
85 Old Eagle School Rd
Suite 200-Second Floor
Strafford, PA 19087-2556
Phone (610) 688-1636
Other providers in Strafford, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 15, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.