Provider Demographics
NPI:1801236237
Name:HUMPAL, JAMIE (LPC)
Entity type:Individual
Prefix:MISS
First Name:JAMIE
Middle Name:
Last Name:HUMPAL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:
Other - Last Name:MERSHON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:12526 LA MANANA ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78233-6331
Mailing Address - Country:US
Mailing Address - Phone:210-273-8372
Mailing Address - Fax:
Practice Address - Street 1:96 CROSSROADS BLVD STE 250
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78201-6523
Practice Address - Country:US
Practice Address - Phone:210-736-0106
Practice Address - Fax:210-736-2609
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-30
Last Update Date:2013-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68530171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor