Provider Demographics
NPI:1235570433
Name:ENRIGHT, JENNA (MA, LCPC)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:ENRIGHT
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 SEWARD ST APT 2
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-5327
Mailing Address - Country:US
Mailing Address - Phone:440-488-9953
Mailing Address - Fax:
Practice Address - Street 1:8445 MUNSON RD
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-2410
Practice Address - Country:US
Practice Address - Phone:440-255-1700
Practice Address - Fax:440-205-2417
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-16
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1300027-CR101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1356303911Medicaid