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General NPI Number Information
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NPI Number | 1548447444
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Entity Type | Individual
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Provider Name | JORDAN ELYSE CUPELLI-KNIGHT MS, CAADC, LPC
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Gender | Female
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Dates
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Enumeration Date | 01/23/2008
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Last Update Date | 03/02/2020
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Provider Practice Location Address
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Address Line | 701 CUMBERLAND ST STE 211
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City | LEBANON
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State | PA
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Zip | 17042-5231
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Country | US
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Telephone | 717-514-2804
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Fax |
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Provider Business Mailing Address
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Address Line | 120 TIVERTON CT
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City | LEBANON
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State | PA
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Zip | 17042-4160
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Country | US
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Telephone | 717-514-2804
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC005947
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License Number State | PA
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