Provider Demographics
NPI:1598150740
Name:SEPP, JACLYN N (MA, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:JACLYN
Middle Name:N
Last Name:SEPP
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2520 LONGVIEW ST
Mailing Address - Street 2:SUITE 212
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-4250
Mailing Address - Country:US
Mailing Address - Phone:512-762-4030
Mailing Address - Fax:
Practice Address - Street 1:2520 LONGVIEW ST
Practice Address - Street 2:SUITE 212
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-4250
Practice Address - Country:US
Practice Address - Phone:512-762-4030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-04
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70570101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional