MEDICARE: JAY PADGE 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	101Y00000X	Counselor	PC016818	PA

General Provider Information

NPI Number	:	1922606102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAY PADGE LPC

Provider Business Mailing Address
First Line	:	1624 FRANKLIN ST
Second Line	:
City	:	JOHNSTOWN
State	:	PA
Zip	:	15905-3815
Country	:	US
Telephone Number	:	814-262-8391
Fax Number	:	814-410-2875

Provider Business Practice Location Address
First Line	:	1624 FRANKLIN ST
Second Line	:
City	:	JOHNSTOWN
State	:	PA
Zip	:	15905-3815
Country	:	US
Telephone Number	:	814-244-5802
Fax Number	:

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

Provider Enumeration Date	:	10/11/2020
Last Update Date	:	04/10/2026

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