Healthcare Provider Details

I. General information

NPI: 1114686060
Provider Name (Legal Business Name): JESSICA LYNN PLONSKY LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2021
Last Update Date: 09/11/2025
Certification Date: 12/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 S STATE ST
CLARKS SUMMIT PA
18411-1684
US

IV. Provider business mailing address

907 BUSH ST
OLYPHANT PA
18447-2201
US

V. Phone/Fax

Practice location:
  • Phone: 570-335-1056
  • Fax:
Mailing address:
  • Phone: 570-335-1056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC013964
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: