Provider Demographics
NPI:1356636765
Name:JENNINGS, BARBARA BERNICE (LCSW)
Entity type:Individual
Prefix:MISS
First Name:BARBARA
Middle Name:BERNICE
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 ASPHODEL ST
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-6472
Mailing Address - Country:US
Mailing Address - Phone:985-414-4370
Mailing Address - Fax:
Practice Address - Street 1:103 ASPHODEL ST
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-6472
Practice Address - Country:US
Practice Address - Phone:985-414-4370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-14
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA50711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical