Provider Demographics
NPI:1740955533
Name:DOUCET, JENNIFER MARIE (DSW, LCSW, MSW)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:MARIE
Last Name:DOUCET
Suffix:
Gender:F
Credentials:DSW, LCSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10066 S HILL TER APT 209
Mailing Address - Street 2:
Mailing Address - City:PALOS HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60465-1270
Mailing Address - Country:US
Mailing Address - Phone:872-237-0434
Mailing Address - Fax:
Practice Address - Street 1:10066 S HILL TER APT 209
Practice Address - Street 2:
Practice Address - City:PALOS HILLS
Practice Address - State:IL
Practice Address - Zip Code:60465-1270
Practice Address - Country:US
Practice Address - Phone:872-222-9974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-12
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0190061041C0700X
LA161841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical