Healthcare Provider Details

I. General information

NPI: 1801786934
Provider Name (Legal Business Name): JENNA ATKINSON LAPC, R-DMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2025
Last Update Date: 08/07/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2047 PA-309
ALLENTOWN PA
18104
US

IV. Provider business mailing address

480 WEDGEWOOD DR
EASTON PA
18045-5753
US

V. Phone/Fax

Practice location:
  • Phone: 484-276-4646
  • Fax:
Mailing address:
  • Phone: 908-442-4577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225600000X
TaxonomyDance Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAPC001538
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: