Provider Demographics
NPI:1467082487
Name:HENRY, JENNIVE ANDREA (MS, NCC, LPC, CST)
Entity type:Individual
Prefix:
First Name:JENNIVE
Middle Name:ANDREA
Last Name:HENRY
Suffix:
Gender:F
Credentials:MS, NCC, LPC, CST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12790 FM 1560 N UNIT 704
Mailing Address - Street 2:
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023-2230
Mailing Address - Country:US
Mailing Address - Phone:210-201-6904
Mailing Address - Fax:
Practice Address - Street 1:9602 TURQUOISE CRK
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78254-6761
Practice Address - Country:US
Practice Address - Phone:361-676-2659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-17
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79275101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty