MEDICARE: JEANNE FAZEKAS LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	PC013075	PA

General Provider Information

NPI Number	:	1699445932
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANNE FAZEKAS LPC

Provider Business Mailing Address
First Line	:	522 ALEXANDER AVE
Second Line	:
City	:	GREENSBURG
State	:	PA
Zip	:	15601-4018
Country	:	US
Telephone Number	:	724-396-4271
Fax Number	:

Provider Business Practice Location Address
First Line	:	522 ALEXANDER AVE
Second Line	:
City	:	GREENSBURG
State	:	PA
Zip	:	15601-4018
Country	:	US
Telephone Number	:	724-396-4271
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/17/2021
Last Update Date	:	09/17/2021

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Directions to “ JEANNE FAZEKAS LPC” Practice Location

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