Provider Demographics
NPI:1649510694
Name:ESCLOVON, JENIFFER KAY (MED, LPC)
Entity type:Individual
Prefix:
First Name:JENIFFER
Middle Name:KAY
Last Name:ESCLOVON
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6300 WEST LOOP S STE 110
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-2919
Mailing Address - Country:US
Mailing Address - Phone:409-626-1329
Mailing Address - Fax:832-852-5754
Practice Address - Street 1:6300 WEST LOOP S STE 110
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-2919
Practice Address - Country:US
Practice Address - Phone:409-626-1329
Practice Address - Fax:832-852-5754
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-27
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14572101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional