Provider Demographics
NPI:1063245199
Name:KUNSMAN LISTER, JAYMEE-LEIGH (MA, LACP)
Entity type:Individual
Prefix:MRS
First Name:JAYMEE-LEIGH
Middle Name:
Last Name:KUNSMAN LISTER
Suffix:
Gender:F
Credentials:MA, LACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 BROWNS DR
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042-9439
Mailing Address - Country:US
Mailing Address - Phone:610-730-0015
Mailing Address - Fax:
Practice Address - Street 1:175 S 21ST ST
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-3835
Practice Address - Country:US
Practice Address - Phone:484-497-9699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAPC000221101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional