Provider Demographics
NPI:1114370871
Name:JAMES, JENIFER NICHELE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JENIFER
Middle Name:NICHELE
Last Name:JAMES
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 1:24385 WILDERNESS OAK APT 8402
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-7766
Mailing Address - Country:US
Mailing Address - Phone:517-505-6424
Mailing Address - Fax:
Practice Address - Street 1:645 N WALNUT AVE
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-7925
Practice Address - Country:US
Practice Address - Phone:830-730-6090
Practice Address - Fax:830-455-4355
Is Sole Proprietor?:No
Enumeration Date:2016-07-18
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401016546101Y00000X
101YP2500X, 247200000X
TX87199101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1114370871Medicaid