Provider Demographics
NPI:1750750683
Name:WHITEFOOT, JENNA (MA, LPC, NCC)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:WHITEFOOT
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:
Other - Last Name:WHITEFOOT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10831 S WOODFIELD CIR
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48114-9292
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:734-436-4994
Practice Address - Street 1:10831 S WOODFIELD CIR
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48114-9292
Practice Address - Country:US
Practice Address - Phone:734-765-3111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-22
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401014880101YM0800X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health