Provider Demographics
NPI:1528476033
Name:LANDI, GENNARO (LPC,CADC,CCDP)
Entity type:Individual
Prefix:MR
First Name:GENNARO
Middle Name:
Last Name:LANDI
Suffix:
Gender:M
Credentials:LPC,CADC,CCDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 S 22ND ST
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042-3811
Mailing Address - Country:US
Mailing Address - Phone:610-905-1484
Mailing Address - Fax:
Practice Address - Street 1:301 S 22ND ST
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-3811
Practice Address - Country:US
Practice Address - Phone:610-905-1484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-28
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007698101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional