Provider Demographics
NPI:1497057277
Name:PRICE, JENNIFER JANE (LMHC)
Entity Type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:JANE
Last Name:PRICE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6605 PITTSFORD PALMYRA RD STE E8
Mailing Address - Street 2:
Mailing Address - City:FAIRPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14450-3405
Mailing Address - Country:US
Mailing Address - Phone:585-760-4090
Mailing Address - Fax:
Practice Address - Street 1:6 N MAIN ST
Practice Address - Street 2:SUITE 400 E
Practice Address - City:FAIRPORT
Practice Address - State:NY
Practice Address - Zip Code:14450-1524
Practice Address - Country:US
Practice Address - Phone:585-315-6379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-29
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004459101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health