Provider Demographics
NPI:1497928402
Name:GOODALL, JENA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JENA
Middle Name:
Last Name:GOODALL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:JENA
Other - Middle Name:
Other - Last Name:STEELE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3955 S FARM ROAD 223
Mailing Address - Street 2:
Mailing Address - City:ROGERSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65742-8807
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3955 S. FR 223
Practice Address - Street 2:
Practice Address - City:ROGERSVILLE
Practice Address - State:MO
Practice Address - Zip Code:65742-4264
Practice Address - Country:US
Practice Address - Phone:417-812-4440
Practice Address - Fax:417-208-5880
Is Sole Proprietor?:No
Enumeration Date:2008-04-10
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007016485101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional