Provider Demographics
NPI:1316361959
Name:YEPMA, JENNIFER LEA (LCSW-S)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LEA
Last Name:YEPMA
Suffix:
Gender:F
Credentials:LCSW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 STEELE
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-5882
Mailing Address - Country:US
Mailing Address - Phone:254-300-9955
Mailing Address - Fax:
Practice Address - Street 1:110 S 12TH ST
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76701-1810
Practice Address - Country:US
Practice Address - Phone:254-752-3451
Practice Address - Fax:254-756-3133
Is Sole Proprietor?:No
Enumeration Date:2014-02-18
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX562431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical