Provider Demographics
NPI:1033848015
Name:DUTIL, JENNIFER LEIGH PEARCE (LMHC, NCC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LEIGH PEARCE
Last Name:DUTIL
Suffix:
Gender:F
Credentials:LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33081 SAND CREEK DR
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-4504
Mailing Address - Country:US
Mailing Address - Phone:732-977-7503
Mailing Address - Fax:
Practice Address - Street 1:33081 SAND CREEK DR
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33543-4504
Practice Address - Country:US
Practice Address - Phone:732-977-7503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH20104101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health