Provider Demographics
NPI:1518993088
Name:DOEHLA, JENNIFER SPINNEWEBER (LPCC)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:SPINNEWEBER
Last Name:DOEHLA
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:SPINNEWEBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:28 PARK AVE W
Mailing Address - Street 2:SUITE # 706
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44902-1648
Mailing Address - Country:US
Mailing Address - Phone:828-772-4725
Mailing Address - Fax:
Practice Address - Street 1:28 PARK AVE W
Practice Address - Street 2:SUITE # 706
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44902-1648
Practice Address - Country:US
Practice Address - Phone:828-772-4725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-24
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE1300084101YP2500X
NC5184101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1518993088OtherNATIONAL PROVIDER IDENTIFICATION NUMBER
NC1412COtherBLUE CROSS BLUE SHIELDS
NC6103150Medicaid