Provider Demographics
NPI:1255587226
Name:MADERE, JENNIFER ANN (LPC)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:ANN
Last Name:MADERE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 CHISHOLM TRL STE 301
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-2969
Mailing Address - Country:US
Mailing Address - Phone:512-762-4762
Mailing Address - Fax:512-248-9833
Practice Address - Street 1:1311 CHISHOLM TRL STE 301
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-2969
Practice Address - Country:US
Practice Address - Phone:512-762-4762
Practice Address - Fax:512-248-9833
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-11
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health