Provider Demographics
NPI:1700205317
Name:JENNIFER SARGENT COUNSELING
Entity Type:Organization
Organization Name:JENNIFER SARGENT COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:REBECCA
Authorized Official - Last Name:SARGENT
Authorized Official - Suffix:
Authorized Official - Credentials:MED LPC
Authorized Official - Phone:405-213-6370
Mailing Address - Street 1:PO BOX 720540
Mailing Address - Street 2:
Mailing Address - City:OKC
Mailing Address - State:OK
Mailing Address - Zip Code:73172
Mailing Address - Country:US
Mailing Address - Phone:405-213-6370
Mailing Address - Fax:
Practice Address - Street 1:8500 NW 164TH STREET
Practice Address - Street 2:
Practice Address - City:EDMON
Practice Address - State:OK
Practice Address - Zip Code:73013
Practice Address - Country:US
Practice Address - Phone:405-213-6370
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-10
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4899101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty