Provider Demographics
NPI:1275941940
Name:MILLNER, JENNIFER R (LCPC, NCC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:R
Last Name:MILLNER
Suffix:
Gender:F
Credentials:LCPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1902 W DICKERSON ST STE 208
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-6852
Mailing Address - Country:US
Mailing Address - Phone:406-579-5197
Mailing Address - Fax:
Practice Address - Street 1:1902 W DICKERSON ST STE 208
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-6852
Practice Address - Country:US
Practice Address - Phone:406-579-5197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-25
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT8077101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health