Provider Demographics
NPI:1437023561
Name:JAMES, JENNIFER LYNN (BCPCC,LPC,IMCA,DDIV,)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:JAMES
Suffix:
Gender:F
Credentials:BCPCC,LPC,IMCA,DDIV,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1535 W CLOUD RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-9505
Mailing Address - Country:US
Mailing Address - Phone:602-320-3823
Mailing Address - Fax:
Practice Address - Street 1:1535 W CLOUD RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85086-9505
Practice Address - Country:US
Practice Address - Phone:602-320-3823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-01
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0001-2024101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Single Specialty