Provider Demographics
NPI:1417589714
Name:PRICE, JENNIFER LYNN (LPC-INTERN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:PRICE
Suffix:
Gender:F
Credentials:LPC-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 9TH AVE N
Mailing Address - Street 2:
Mailing Address - City:TEXAS CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77590-5472
Mailing Address - Country:US
Mailing Address - Phone:409-643-5930
Mailing Address - Fax:409-643-5952
Practice Address - Street 1:1801 9TH AVE N
Practice Address - Street 2:
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77590-5472
Practice Address - Country:US
Practice Address - Phone:409-643-5930
Practice Address - Fax:409-643-5952
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-05
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81858101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health