Provider Demographics
NPI:1821458647
Name:HUNTER, JADE (LPC)
Entity Type:Individual
Prefix:
First Name:JADE
Middle Name:
Last Name:HUNTER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8101 MEMORIAL LN APT 3212
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-2260
Mailing Address - Country:US
Mailing Address - Phone:817-966-6266
Mailing Address - Fax:
Practice Address - Street 1:3603 W PIONEER PKWY STE A
Practice Address - Street 2:
Practice Address - City:PANTEGO
Practice Address - State:TX
Practice Address - Zip Code:76013-4535
Practice Address - Country:US
Practice Address - Phone:817-402-2841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-07
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP1600X
TX69889101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral