Provider Demographics
NPI:1750315156
Name:WILLIAMS, JENNIFER GUTHRIDGE (MS, LMHC)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:GUTHRIDGE
Last Name:WILLIAMS
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Gender:F
Credentials:MS, LMHC
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Mailing Address - Street 1:3802 W 96TH ST
Mailing Address - Street 2:SUITE 220
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-2921
Mailing Address - Country:US
Mailing Address - Phone:317-471-8780
Mailing Address - Fax:317-471-8782
Practice Address - Street 1:3802 W 96TH ST
Practice Address - Street 2:SUITE 220
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-2921
Practice Address - Country:US
Practice Address - Phone:317-471-8780
Practice Address - Fax:317-471-8782
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN39001515A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN39001515AOtherLICENSE - LMHC