Provider Demographics
NPI:1851063770
Name:GALYON, JENNIFER (LPC-MHSP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:GALYON
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:JENNY
Other - Middle Name:
Other - Last Name:GALYON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC-MHSP
Mailing Address - Street 1:595 PINEWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-1230
Mailing Address - Country:US
Mailing Address - Phone:423-839-4840
Mailing Address - Fax:
Practice Address - Street 1:1079 E MORRIS BLVD
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37813-5901
Practice Address - Country:US
Practice Address - Phone:423-318-7373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-29
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5583101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional