Provider Demographics
NPI:1457496549
Name:CAIN, JENNIFER J (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:J
Last Name:CAIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 SPRING HILL DR
Mailing Address - Street 2:STE 360
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77386-6027
Mailing Address - Country:US
Mailing Address - Phone:281-239-4306
Mailing Address - Fax:
Practice Address - Street 1:504 SPRING HILL DR
Practice Address - Street 2:STE 360
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77386-6027
Practice Address - Country:US
Practice Address - Phone:281-239-4306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18778101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX735ILCOtherBC BS PROVIDER NUMBER