Provider Demographics
NPI:1073820387
Name:OXFORD, JENNIFER R (LPC, CMHC)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:R
Last Name:OXFORD
Suffix:
Gender:F
Credentials:LPC, CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3305 FORT ST
Mailing Address - Street 2:
Mailing Address - City:ROYSE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:75189-3292
Mailing Address - Country:US
Mailing Address - Phone:208-521-0722
Mailing Address - Fax:
Practice Address - Street 1:3305 FORT ST
Practice Address - Street 2:
Practice Address - City:ROYSE CITY
Practice Address - State:TX
Practice Address - Zip Code:75189-3292
Practice Address - Country:US
Practice Address - Phone:208-521-0722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-08
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90191101YM0800X, 101Y00000X
ID5142101YP2500X
UT7602454-3503104100000X
UT7602454-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1346368198Medicaid