Provider Demographics
NPI:1558382101
Name:WHITCOMB, JENNIFER F (PHD, LPC, LMFT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:F
Last Name:WHITCOMB
Suffix:
Gender:F
Credentials:PHD, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5004 HIGHWAY 39 N
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39301-1021
Mailing Address - Country:US
Mailing Address - Phone:601-693-8307
Mailing Address - Fax:601-693-6794
Practice Address - Street 1:5004 HIGHWAY 39 N
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39301-1021
Practice Address - Country:US
Practice Address - Phone:601-693-8307
Practice Address - Fax:601-693-6794
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS0654101YP2500X
MST0377106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist