Provider Demographics
NPI:1164654752
Name:STROLE, JENNIFER (MSED, NCC, LPC)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:STROLE
Suffix:
Gender:F
Credentials:MSED, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 DOLLY ST
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:GA
Mailing Address - Zip Code:31032-5307
Mailing Address - Country:US
Mailing Address - Phone:478-457-5719
Mailing Address - Fax:
Practice Address - Street 1:111 DOLLY ST
Practice Address - Street 2:
Practice Address - City:GRAY
Practice Address - State:GA
Practice Address - Zip Code:31032-5307
Practice Address - Country:US
Practice Address - Phone:478-457-5719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-14
Last Update Date:2009-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005066101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional