Provider Demographics
NPI:1467173872
Name:JENNINGS, KATELYN JASANNA (MS, NCC)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:JASANNA
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:MS, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:277 HORSE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:CHUCKEY
Mailing Address - State:TN
Mailing Address - Zip Code:37641-2627
Mailing Address - Country:US
Mailing Address - Phone:423-607-1325
Mailing Address - Fax:
Practice Address - Street 1:906 TUSCULUM BLVD
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-4065
Practice Address - Country:US
Practice Address - Phone:865-378-6929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor