Provider Demographics
NPI:1720272214
Name:URBACH, JENNIFER CHAPPLE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:CHAPPLE
Last Name:URBACH
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 1:2539 S GESSNER RD
Mailing Address - Street 2:SUITE 24
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-2034
Mailing Address - Country:US
Mailing Address - Phone:713-963-0233
Mailing Address - Fax:713-264-8638
Practice Address - Street 1:2539 S GESSNER RD
Practice Address - Street 2:SUITE 24
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-2034
Practice Address - Country:US
Practice Address - Phone:713-392-4747
Practice Address - Fax:713-264-8638
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-28
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX350701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical