Provider Demographics
NPI:1013729284
Name:FITCHLEE, JENNA (MA, LPC ASSOCIATE)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:FITCHLEE
Suffix:
Gender:F
Credentials:MA, LPC ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11010 HARMONY HILL LN APT 1205
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75089-0137
Mailing Address - Country:US
Mailing Address - Phone:912-850-2092
Mailing Address - Fax:
Practice Address - Street 1:505 WOODBRIDGE PKWY STE 300
Practice Address - Street 2:
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-7127
Practice Address - Country:US
Practice Address - Phone:972-989-7655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX97683101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional