Provider Demographics
NPI:1619733268
Name:CAVENDER, JAY (LPC)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:
Last Name:CAVENDER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 EARNHARDT DR
Mailing Address - Street 2:
Mailing Address - City:NEW MARKET
Mailing Address - State:AL
Mailing Address - Zip Code:35761-7919
Mailing Address - Country:US
Mailing Address - Phone:256-479-0257
Mailing Address - Fax:
Practice Address - Street 1:2010 S POINT PARK CIR STE 200
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5478
Practice Address - Country:US
Practice Address - Phone:256-880-5818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty