Provider Demographics
NPI:1619429438
Name:JENNINGS, JOCELYN B (LMFT)
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:B
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 HENRY AVE
Mailing Address - Street 2:3RD FLOOR, SUITE 302
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19129-1121
Mailing Address - Country:US
Mailing Address - Phone:215-924-0684
Mailing Address - Fax:215-924-3805
Practice Address - Street 1:3300 HENRY AVE
Practice Address - Street 2:3RD FLOOR, SUITE 302
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19129-1121
Practice Address - Country:US
Practice Address - Phone:215-924-0684
Practice Address - Fax:215-924-3805
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-27
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000679106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist