Provider Demographics
NPI:1093258600
Name:HUBERT, JENNIFER JULES (LCSW, BSN, RN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JULES
Last Name:HUBERT
Suffix:
Gender:F
Credentials:LCSW, BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2738 W THARPE ST APT 2004
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-8513
Mailing Address - Country:US
Mailing Address - Phone:561-324-6109
Mailing Address - Fax:
Practice Address - Street 1:2738 W THARPE ST APT 2004
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-8513
Practice Address - Country:US
Practice Address - Phone:561-324-6109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-30
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL59-196-4034101Y00000X
FLSW187061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor