Provider Demographics
NPI:1033496260
Name:CARRON, JENEVA (MA, LMHC, LPCC, CCTP)
Entity Type:Individual
Prefix:MRS
First Name:JENEVA
Middle Name:
Last Name:CARRON
Suffix:
Gender:F
Credentials:MA, LMHC, LPCC, CCTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8155 RED BUD CT
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-1182
Mailing Address - Country:US
Mailing Address - Phone:812-202-0953
Mailing Address - Fax:888-388-0795
Practice Address - Street 1:8155 RED BUD CT
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-1182
Practice Address - Country:US
Practice Address - Phone:812-202-0953
Practice Address - Fax:888-388-0795
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-16
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39003550A101YM0800X, 101YP2500X
KY246176101YM0800X, 101YP2500X
101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral