Provider Demographics
NPI:1225347594
Name:HOWELL, JENNIFER A (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:A
Last Name:HOWELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:JENNIFER
Other - Middle Name:A
Other - Last Name:NIELSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:4621 S 195TH EAST AVE
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74014-8065
Mailing Address - Country:US
Mailing Address - Phone:918-809-5022
Mailing Address - Fax:
Practice Address - Street 1:4621 S 195TH EAST AVE
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74014-8065
Practice Address - Country:US
Practice Address - Phone:918-809-5022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3895101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health