Provider Demographics
NPI:1801428065
Name:NEVINS, JENNIFER R (MS, LMHC, NCC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:R
Last Name:NEVINS
Suffix:
Gender:F
Credentials:MS, LMHC, NCC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:NEVINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, LMHC, NCC
Mailing Address - Street 1:2782 110TH ST
Mailing Address - Street 2:
Mailing Address - City:ELLIOTT
Mailing Address - State:IA
Mailing Address - Zip Code:51532-5007
Mailing Address - Country:US
Mailing Address - Phone:402-212-6317
Mailing Address - Fax:
Practice Address - Street 1:808 E 7TH ST
Practice Address - Street 2:
Practice Address - City:ATLANTIC
Practice Address - State:IA
Practice Address - Zip Code:50022-1805
Practice Address - Country:US
Practice Address - Phone:712-352-0917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-06
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA099339101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health