Provider Demographics
NPI:1265826051
Name:NOLD, JENIFER (LPC)
Entity Type:Individual
Prefix:
First Name:JENIFER
Middle Name:
Last Name:NOLD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10310 N 138TH EAST AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-4611
Mailing Address - Country:US
Mailing Address - Phone:539-210-3847
Mailing Address - Fax:
Practice Address - Street 1:10310 N 138TH EAST AVE STE 101
Practice Address - Street 2:
Practice Address - City:OWASSO
Practice Address - State:OK
Practice Address - Zip Code:74055-4611
Practice Address - Country:US
Practice Address - Phone:539-210-3847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-19
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor