Provider Demographics
NPI:1528473048
Name:LENHART, JILL
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:LENHART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 WOODSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:MERTZTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19539-9025
Mailing Address - Country:US
Mailing Address - Phone:610-682-0242
Mailing Address - Fax:
Practice Address - Street 1:703 WOODSIDE AVE
Practice Address - Street 2:
Practice Address - City:MERTZTOWN
Practice Address - State:PA
Practice Address - Zip Code:19539-9025
Practice Address - Country:US
Practice Address - Phone:610-682-0242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-23
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH002124103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst