Provider Demographics
NPI:1518175785
Name:JENNINGS, JOANNE LOUISE (MSW, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:LOUISE
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:MSW, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 OXBORO CIR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-8297
Mailing Address - Country:US
Mailing Address - Phone:919-544-1641
Mailing Address - Fax:
Practice Address - Street 1:3325 DURHAM CHAPEL HILL BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-6235
Practice Address - Country:US
Practice Address - Phone:919-419-1493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC652106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist