Provider Demographics
NPI:1417010711
Name:TOWNSEND, JEANNA DESENFANTS (LMHP, CPC)
Entity Type:Individual
Prefix:MS
First Name:JEANNA
Middle Name:DESENFANTS
Last Name:TOWNSEND
Suffix:
Gender:F
Credentials:LMHP, CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2208 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-1970
Mailing Address - Country:US
Mailing Address - Phone:308-632-8084
Mailing Address - Fax:308-632-8084
Practice Address - Street 1:2208 BROADWAY
Practice Address - Street 2:
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-1970
Practice Address - Country:US
Practice Address - Phone:308-632-8084
Practice Address - Fax:308-632-8084
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2370101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional