Provider Demographics
NPI:1356614614
Name:FIRMIN, JENNIFER SMITH (MA, LPC-S)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:SMITH
Last Name:FIRMIN
Suffix:
Gender:F
Credentials:MA, LPC-S
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:SMITH
Other - Last Name:MCDOWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LPC-S
Mailing Address - Street 1:250 MCDOWELL RD
Mailing Address - Street 2:
Mailing Address - City:HESSMER
Mailing Address - State:LA
Mailing Address - Zip Code:71341-4165
Mailing Address - Country:US
Mailing Address - Phone:318-201-0818
Mailing Address - Fax:
Practice Address - Street 1:3330 MASONIC DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-3841
Practice Address - Country:US
Practice Address - Phone:318-448-6530
Practice Address - Fax:318-985-2140
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-17
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3418101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional