Provider Demographics
NPI:1942238076
Name:HAUPT, JEANNIE E (LPC)
Entity Type:Individual
Prefix:MS
First Name:JEANNIE
Middle Name:E
Last Name:HAUPT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MISS
Other - First Name:JEANNIE
Other - Middle Name:E
Other - Last Name:DUNN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:6413 EAGLE XING
Mailing Address - Street 2:
Mailing Address - City:OSAGE BEACH
Mailing Address - State:MO
Mailing Address - Zip Code:65065-9812
Mailing Address - Country:US
Mailing Address - Phone:573-579-6536
Mailing Address - Fax:573-579-6536
Practice Address - Street 1:119 N BENTON ST
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:MO
Practice Address - Zip Code:65583-2501
Practice Address - Country:US
Practice Address - Phone:573-433-2833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1999142232101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO495719825Medicaid
561886OtherHEALTHLINK
MO188208OtherBC/BS