Provider Demographics
NPI:1912044009
Name:CLINE, JENNIFER LYNN (PHD, LPC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:LYNN
Last Name:CLINE
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:HATTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:726 BURKETOWN RD
Mailing Address - Street 2:
Mailing Address - City:WEYERS CAVE
Mailing Address - State:VA
Mailing Address - Zip Code:24486-2106
Mailing Address - Country:US
Mailing Address - Phone:540-649-5570
Mailing Address - Fax:540-266-3846
Practice Address - Street 1:1181 SMITH AVENUE
Practice Address - Street 2:EMU
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22802
Practice Address - Country:US
Practice Address - Phone:540-432-4213
Practice Address - Fax:540-266-3846
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003635101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
918OtherAPPROVED CLINICAL SUPERVISOR
VA010092574Medicaid
VA0701003635OtherLICENSED PROFESSIONAL COUNSELOR