Provider Demographics
NPI:1770880593
Name:JACOBS, JENNY (LPC)
Entity type:Individual
Prefix:MRS
First Name:JENNY
Middle Name:
Last Name:JACOBS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 STONEHOLLOW DR
Mailing Address - Street 2:A
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-1789
Mailing Address - Country:US
Mailing Address - Phone:713-364-8032
Mailing Address - Fax:832-442-3012
Practice Address - Street 1:5610 RAPID BROOK CT
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77345-1922
Practice Address - Country:US
Practice Address - Phone:713-364-8032
Practice Address - Fax:832-442-3012
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-14
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64688101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health