Provider Demographics
NPI:1720131899
Name:JAMES, JENNIFER EDITH (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:EDITH
Last Name:JAMES
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 1:814 E. BAMBERGER DRIVE SUITE B
Mailing Address - Street 2:PSYCHOLOGICAL ASSESSMENT & TREATMENT SPECIALISTS, INC.
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003
Mailing Address - Country:US
Mailing Address - Phone:801-772-0202
Mailing Address - Fax:801-772-0139
Practice Address - Street 1:814 E. BAMBERGER DRIVE SUITE B
Practice Address - Street 2:PSYCHOLOGICAL ASSESSMENT & TREATMENT SPECIALISTS, INC.
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003
Practice Address - Country:US
Practice Address - Phone:801-772-0202
Practice Address - Fax:801-772-0139
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5912235-35021041C0700X
UT5912235-3501 LCSW106H00000X, 101Y00000X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No104100000XBehavioral Health & Social Service ProvidersSocial Worker