Provider Demographics
NPI:1003779711
Name:DONCHES, JACK
Entity type:Individual
Prefix:
First Name:JACK
Middle Name:
Last Name:DONCHES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 WINDSOR AVE
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-3308
Mailing Address - Country:US
Mailing Address - Phone:610-716-9375
Mailing Address - Fax:
Practice Address - Street 1:2370 YORK RD STE C3
Practice Address - Street 2:
Practice Address - City:JAMISON
Practice Address - State:PA
Practice Address - Zip Code:18929-1031
Practice Address - Country:US
Practice Address - Phone:267-563-8180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-12-09
Last Update Date:2025-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAPC001950101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health