Provider Demographics
NPI:1730117128
Name:JENNINGS, SARA LYNN (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:LYNN
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11601 RM 1061
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79124-4770
Mailing Address - Country:US
Mailing Address - Phone:806-282-1137
Mailing Address - Fax:806-356-9046
Practice Address - Street 1:3014 W 26TH AVE
Practice Address - Street 2:SUITE 4000
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-3176
Practice Address - Country:US
Practice Address - Phone:806-282-1137
Practice Address - Fax:806-356-9046
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19378101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional