Provider Demographics
NPI:1639361926
Name:DEMUTH, JEFFERY BLAIR (LPC)
Entity Type:Individual
Prefix:MR
First Name:JEFFERY
Middle Name:BLAIR
Last Name:DEMUTH
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2929 CALDER ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77702-1845
Mailing Address - Country:US
Mailing Address - Phone:409-833-9797
Mailing Address - Fax:409-654-6886
Practice Address - Street 1:2929 CALDER ST
Practice Address - Street 2:SUITE 100
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702-1845
Practice Address - Country:US
Practice Address - Phone:409-833-9797
Practice Address - Fax:409-654-6925
Is Sole Proprietor?:No
Enumeration Date:2007-08-10
Last Update Date:2015-12-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX61665101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional