Healthcare Provider Details

I. General information

NPI: 1851936488
Provider Name (Legal Business Name): JAYCIE JABCO LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2019
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2018 MAPLE ST
LANSE PA
16849-1036
US

IV. Provider business mailing address

1172 CLARENCE RD
CLARENCE PA
16829-8001
US

V. Phone/Fax

Practice location:
  • Phone: 814-345-5550
  • Fax:
Mailing address:
  • Phone: 717-487-8857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: