Provider Demographics
NPI:1861044646
Name:DEJARNETTE, NATALIE LYNN (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:LYNN
Last Name:DEJARNETTE
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 CEDAR RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:NOLANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76559-4611
Mailing Address - Country:US
Mailing Address - Phone:405-361-0885
Mailing Address - Fax:
Practice Address - Street 1:106 CEDAR RIDGE DR
Practice Address - Street 2:
Practice Address - City:NOLANVILLE
Practice Address - State:TX
Practice Address - Zip Code:76559-4611
Practice Address - Country:US
Practice Address - Phone:405-361-0885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-12
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78498101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty