Healthcare Provider Details

I. General information

NPI: 1861238982
Provider Name (Legal Business Name): KAITLIN JANESKO LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2024
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1416 MONROE AVE STE 205
DUNMORE PA
18509-2477
US

IV. Provider business mailing address

604 CONNELL ST
SCRANTON PA
18505-3302
US

V. Phone/Fax

Practice location:
  • Phone: 570-871-0851
  • Fax: 570-906-8333
Mailing address:
  • Phone: 570-955-8786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC017846
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: