Provider Demographics
NPI:1417952409
Name:HANCOCK, JEANIE (MED, LPC)
Entity Type:Individual
Prefix:
First Name:JEANIE
Middle Name:
Last Name:HANCOCK
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 LEGEND LN
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-5421
Mailing Address - Country:US
Mailing Address - Phone:903-891-8687
Mailing Address - Fax:903-892-4934
Practice Address - Street 1:115 S TRAVIS ST
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-5990
Practice Address - Country:US
Practice Address - Phone:903-891-8687
Practice Address - Fax:903-892-4934
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16689101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health