Provider Demographics
NPI:1922571876
Name:GOBEL, JENNIFER M (CT, LPC)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:M
Last Name:GOBEL
Suffix:
Gender:F
Credentials:CT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1251 NILLES RD STE 5
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-7205
Mailing Address - Country:US
Mailing Address - Phone:513-939-0300
Mailing Address - Fax:513-939-0310
Practice Address - Street 1:1251 NILLES RD STE 5
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-7205
Practice Address - Country:US
Practice Address - Phone:513-939-0300
Practice Address - Fax:513-939-0310
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-03
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1801488-TRNE101Y00000X
OHC.1902375101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor