Provider Demographics
NPI:1477106532
Name:KAUFMAN, JENNA LEAH (LPC)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:LEAH
Last Name:KAUFMAN
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 1:8566 CORDES CIR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38139-3317
Mailing Address - Country:US
Mailing Address - Phone:901-300-2930
Mailing Address - Fax:901-300-2933
Practice Address - Street 1:8566 CORDES CIR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38139-3317
Practice Address - Country:US
Practice Address - Phone:901-300-2930
Practice Address - Fax:901-300-2933
Is Sole Proprietor?:No
Enumeration Date:2019-07-18
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3903101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional