Provider Demographics
NPI:1508035148
Name:ACCUARDI GAY, JENNIFER LOUISE (LMFT-S)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LOUISE
Last Name:ACCUARDI GAY
Suffix:
Gender:F
Credentials:LMFT-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2728 HOOD ST APT 823
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-5013
Mailing Address - Country:US
Mailing Address - Phone:214-399-0416
Mailing Address - Fax:
Practice Address - Street 1:12801 N CENTRAL EXPY STE 1560
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-1886
Practice Address - Country:US
Practice Address - Phone:214-399-0416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-28
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201190106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1508035148Medicaid