Provider Demographics
NPI:1649703687
Name:RASMUSSEN, JENNIFER (MS, LPC, RPT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:RASMUSSEN
Suffix:
Gender:F
Credentials:MS, LPC, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 WILSON CT
Mailing Address - Street 2:
Mailing Address - City:HUTTO
Mailing Address - State:TX
Mailing Address - Zip Code:78634-4390
Mailing Address - Country:US
Mailing Address - Phone:512-537-7151
Mailing Address - Fax:
Practice Address - Street 1:108 WILSON CT
Practice Address - Street 2:
Practice Address - City:HUTTO
Practice Address - State:TX
Practice Address - Zip Code:78634
Practice Address - Country:US
Practice Address - Phone:512-537-7151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-06
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX74230101YP2500X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional