Provider Demographics
NPI:1689025611
Name:MEADOWS, JENNIFER (MA LPC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:MEADOWS
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:KROCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA LPC
Mailing Address - Street 1:1580 S MAIN ST STE 205
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-3311
Mailing Address - Country:US
Mailing Address - Phone:210-920-5364
Mailing Address - Fax:830-331-8747
Practice Address - Street 1:1580 S MAIN ST STE 205
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-3311
Practice Address - Country:US
Practice Address - Phone:210-920-5364
Practice Address - Fax:830-331-8747
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-30
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71194101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor