Provider Demographics
NPI:1053831966
Name:CROTEAU, JENNIFER M (MS, LMFT-I)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:CROTEAU
Suffix:
Gender:F
Credentials:MS, LMFT-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8025 W RUSSELL RD APT 1038
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-1581
Mailing Address - Country:US
Mailing Address - Phone:603-785-2514
Mailing Address - Fax:
Practice Address - Street 1:8025 W RUSSELL RD
Practice Address - Street 2:APT 1038
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113
Practice Address - Country:US
Practice Address - Phone:603-785-2514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor