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General NPI Number Information
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NPI Number | 1326772393
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Entity Type | Individual
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Provider Name | JONATHAN JAMES CARMELITANO LPC
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Gender | Male
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Dates
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Enumeration Date | 07/14/2022
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Last Update Date | 07/14/2022
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Provider Practice Location Address
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Address Line | 300 S JEFFERSON ST
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City | KITTANNING
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State | PA
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Zip | 16201-2416
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Country | US
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Telephone | 724-545-4592
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Fax |
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Provider Business Mailing Address
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Address Line | 800 COLONY WEST DR APT 9
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City | CORAOPOLIS
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State | PA
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Zip | 15108-2892
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Country | US
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Telephone | 631-275-0862
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | PC014560
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License Number State | PA
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