Provider Demographics
NPI:1184856304
Name:ANDERSON, JENENNE HOWELL (LCPC)
Entity Type:Individual
Prefix:
First Name:JENENNE
Middle Name:HOWELL
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:JENENNE
Other - Middle Name:E
Other - Last Name:HOWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC
Mailing Address - Street 1:2023 STADIUM DR
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-0613
Mailing Address - Country:US
Mailing Address - Phone:406-529-9733
Mailing Address - Fax:
Practice Address - Street 1:2023 STADIUM DR
Practice Address - Street 2:SUITE 1C
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-0613
Practice Address - Country:US
Practice Address - Phone:406-529-9733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-20
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1439101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional