Provider Demographics
NPI:1114551538
Name:JENNIFER HART LMFT LLC
Entity Type:Organization
Organization Name:JENNIFER HART LMFT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HART
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:541-579-8839
Mailing Address - Street 1:927 COUNTRY CLUB RD STE 200
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2272
Mailing Address - Country:US
Mailing Address - Phone:541-579-8839
Mailing Address - Fax:
Practice Address - Street 1:927 COUNTRY CLUB RD STE 200
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2272
Practice Address - Country:US
Practice Address - Phone:541-579-8839
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-25
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health