Jeanne Ann Grymko, L.P.C., C.A.A.D.C.
Individual provider Active NPI Professional Counselor · Forty Fort, PA
NPI 1831460971 · NPPES record last updated Jan 31, 2018
Key facts
- NPI
- 1831460971
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 010090 (PA)
- Practice address
- 15 E Turner St
Forty Fort, PA 18704-4913 - Phone
- (570) 313-6449
- NPI assigned
- Jan 20, 2012
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 010090 | PA | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Professional Counselor | 101YP2500X | 010090 | PA | Yes |
Addresses
Primary practice location
15 E Turner St
Forty Fort, PA 18704-4913
Mailing address
15 E Turner St
Forty Fort, PA 18704-4913
Phone (570) 313-6449
Other names
- Jeanne Ann Davenport
Other providers in Forty Fort, PA
- Elizabeth Gernhardt
- Roy Walter Gernhardt III
- Harold Thomas Glatz
- Kenneth M Granahan
- Robert Edward Griffin
- John Michael Guarnieri
- Louis John Guarnieri
- Nancy M. Guarnieri
- Erica Haefele
- Michaela Hamilton
All providers in Forty Fort, PA · Professional Counselor in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 31, 2018. 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.