Provider Demographics
NPI:1497768402
Name:JAEGER, JENNIFER A (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:A
Last Name:JAEGER
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:PO BOX 290753
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78029-0753
Mailing Address - Country:US
Mailing Address - Phone:830-329-1413
Mailing Address - Fax:830-792-3438
Practice Address - Street 1:160 GUADALUPE PLZ
Practice Address - Street 2:SUITE A
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-4545
Practice Address - Country:US
Practice Address - Phone:830-329-1413
Practice Address - Fax:830-792-3438
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16973101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX142645401Medicaid
TX275450OtherCOMPSYCH
TX5388 LCOtherBLUE CROSS BLUE SHIELD
TX84900LOtherBC/BS OF TX
TX142645404Medicaid