Provider Demographics
NPI:1457873952
Name:KAFROUNI, JESSICA CANFIELD (MA, MED, LPC, LCDC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:CANFIELD
Last Name:KAFROUNI
Suffix:
Gender:F
Credentials:MA, MED, LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:907 S FRIENDSWOOD DR STE 209
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-5489
Mailing Address - Country:US
Mailing Address - Phone:281-450-8375
Mailing Address - Fax:
Practice Address - Street 1:907 S FRIENDSWOOD DR STE 209
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-5489
Practice Address - Country:US
Practice Address - Phone:281-450-8375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-17
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13093101YA0400X
74298101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)