Healthcare Provider Details

I. General information

NPI: 1275522575
Provider Name (Legal Business Name): JODY LEE AURANDT LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2005
Last Update Date: 08/02/2023
Certification Date: 08/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

793 OLD ROUTE 119 HWY N
INDIANA PA
15701-1372
US

IV. Provider business mailing address

793 OLD ROUTE 119 HWY N
INDIANA PA
15701-1372
US

V. Phone/Fax

Practice location:
  • Phone: 724-465-5576
  • Fax: 724-463-3262
Mailing address:
  • Phone: 724-465-5576
  • Fax: 724-463-3262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC000911
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: