Provider Demographics
NPI:1073023255
Name:JAMES, JEANETTE (LPC NCC)
Entity Type:Individual
Prefix:
First Name:JEANETTE
Middle Name:
Last Name:JAMES
Suffix:
Gender:F
Credentials:LPC NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1390 GEORGE DIETER DR STE 140
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-7430
Mailing Address - Country:US
Mailing Address - Phone:915-320-1390
Mailing Address - Fax:
Practice Address - Street 1:5924 DELTA DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-5321
Practice Address - Country:US
Practice Address - Phone:915-320-1390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-02
Last Update Date:2017-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70460101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional