Provider Demographics
NPI:1023213451
Name:SPEARS, JENNIFER LUANNE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LUANNE
Last Name:SPEARS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1630 S KERR BLVD
Mailing Address - Street 2:SALLISAW, OK 74955
Mailing Address - City:SALLISAW
Mailing Address - State:OK
Mailing Address - Zip Code:74955-7240
Mailing Address - Country:US
Mailing Address - Phone:918-790-2653
Mailing Address - Fax:918-790-2657
Practice Address - Street 1:1630 S KERR BLVD
Practice Address - Street 2:
Practice Address - City:SALLISAW
Practice Address - State:OK
Practice Address - Zip Code:74955-7240
Practice Address - Country:US
Practice Address - Phone:918-790-2653
Practice Address - Fax:918-790-2657
Is Sole Proprietor?:No
Enumeration Date:2007-06-16
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health