Provider Demographics
NPI:1003063124
Name:POSTON, JEANENE R (LCSW)
Entity Type:Individual
Prefix:
First Name:JEANENE
Middle Name:R
Last Name:POSTON
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 1:117 W WALKER ST
Mailing Address - Street 2:
Mailing Address - City:BRECKENRIDGE
Mailing Address - State:TX
Mailing Address - Zip Code:76424-3538
Mailing Address - Country:US
Mailing Address - Phone:325-603-5711
Mailing Address - Fax:
Practice Address - Street 1:117 W WALKER ST.
Practice Address - Street 2:
Practice Address - City:BRECKENRIDGE
Practice Address - State:TX
Practice Address - Zip Code:76424
Practice Address - Country:UM
Practice Address - Phone:325-603-5711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-20
Last Update Date:2018-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX607451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical