Provider Demographics
NPI:1124435201
Name:SMETANA, JENNIFER (LCSW)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:SMETANA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1869 ROUTE 739
Mailing Address - Street 2:SUITE 4
Mailing Address - City:DINGMANS FERRY
Mailing Address - State:PA
Mailing Address - Zip Code:18328-3409
Mailing Address - Country:US
Mailing Address - Phone:570-828-7050
Mailing Address - Fax:610-672-9495
Practice Address - Street 1:1869 ROUTE 739
Practice Address - Street 2:SUITE 4
Practice Address - City:DINGMANS FERRY
Practice Address - State:PA
Practice Address - Zip Code:18328-3409
Practice Address - Country:US
Practice Address - Phone:570-828-7050
Practice Address - Fax:610-672-9495
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-21
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0182111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical