Provider Demographics
NPI:1194853127
Name:DUBEN, JENNIFER (LPC-MHSP, PHD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:DUBEN
Suffix:
Gender:F
Credentials:LPC-MHSP, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:173 BELLE FOREST CIR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-2163
Mailing Address - Country:US
Mailing Address - Phone:615-415-2383
Mailing Address - Fax:
Practice Address - Street 1:173 BELLE FOREST CIR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-2163
Practice Address - Country:US
Practice Address - Phone:615-415-2383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000001593101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional