Provider Demographics
NPI:1376863027
Name:BAUER, JENNY WHITTENBURG (MA, LPC)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:WHITTENBURG
Last Name:BAUER
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 FOX GLEN RD
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-3020
Mailing Address - Country:US
Mailing Address - Phone:512-461-4486
Mailing Address - Fax:
Practice Address - Street 1:1208 FOX GLEN RD
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-3020
Practice Address - Country:US
Practice Address - Phone:512-461-4486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-04
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63445101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional