Provider Demographics
NPI:1336308410
Name:JENNINGS COUNSELING SERVICES, PLLC
Entity Type:Organization
Organization Name:JENNINGS COUNSELING SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:JENNINGS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:806-282-1137
Mailing Address - Street 1:3014 SW 26TH AVE
Mailing Address - Street 2:SUITE 4000
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-3176
Mailing Address - Country:US
Mailing Address - Phone:806-282-1137
Mailing Address - Fax:806-356-9046
Practice Address - Street 1:3014 SW 26TH AVE
Practice Address - Street 2:SUITE 4000
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-3176
Practice Address - Country:US
Practice Address - Phone:806-282-1137
Practice Address - Fax:806-356-9046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-04
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19378101YP2500X
TX19387101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX176835002Medicaid
TX172641601Medicaid