Provider Demographics
NPI:1073768511
Name:ENGLAND, JENNIFER AMBER (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:AMBER
Last Name:ENGLAND
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 1:2150 ELDER MILL RD
Mailing Address - Street 2:
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-3300
Mailing Address - Country:US
Mailing Address - Phone:706-476-8073
Mailing Address - Fax:
Practice Address - Street 1:2150 ELDER MILL RD
Practice Address - Street 2:
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-3300
Practice Address - Country:US
Practice Address - Phone:706-476-8073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-25
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC003069101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty