Provider Demographics
NPI:1417321555
Name:FERREN, JENNIFER G (LPC-MHSP, NCC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:G
Last Name:FERREN
Suffix:
Gender:F
Credentials:LPC-MHSP, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:895 S. COOPER STREET
Mailing Address - Street 2:SUITE 1, 2, 3 & 6
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104
Mailing Address - Country:US
Mailing Address - Phone:901-498-9126
Mailing Address - Fax:901-722-5657
Practice Address - Street 1:895 S COOPER ST
Practice Address - Street 2:SUITE 3
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-5604
Practice Address - Country:US
Practice Address - Phone:901-498-9126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-29
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2050101YP2500X
TN3594101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ024104Medicaid