Provider Demographics
NPI:1083091417
Name:HIERS, JENNIFER (LMHC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:HIERS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4721 E MOODY BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:BUNNELL
Mailing Address - State:FL
Mailing Address - Zip Code:32110-7706
Mailing Address - Country:US
Mailing Address - Phone:386-793-9669
Mailing Address - Fax:386-256-1761
Practice Address - Street 1:4721 E MOODY BLVD STE 204
Practice Address - Street 2:
Practice Address - City:BUNNELL
Practice Address - State:FL
Practice Address - Zip Code:32110-7706
Practice Address - Country:US
Practice Address - Phone:386-793-9669
Practice Address - Fax:386-256-1761
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-06
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health