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General NPI Number Information
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NPI Number | 1871150722
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Entity Type | Individual
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Provider Name | JONATHAN MICHAEL REVELEY-COHEN LPC
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Gender | Male
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Dates
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Enumeration Date | 05/28/2019
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 710 MOUNT VERNON AVE STE 1
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City | HUNTINGDON
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State | PA
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Zip | 16652-1274
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Country | US
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Telephone | 814-506-8651
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Fax |
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Provider Business Mailing Address
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Address Line | 201 5TH ST STE 203
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City | HUNTINGDON
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State | PA
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Zip | 16652-1549
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Country | US
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Telephone | 814-251-1696
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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 | PC008839
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | PC008839
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | PC008839
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License Number State | PA
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