Provider Demographics
NPI:1831553155
Name:BROCKWAY, JENNY GARCIA (MS, NCC, LPC)
Entity type:Individual
Prefix:MRS
First Name:JENNY
Middle Name:GARCIA
Last Name:BROCKWAY
Suffix:
Gender:F
Credentials:MS, NCC, LPC
Other - Prefix:MISS
Other - First Name:JENNY
Other - Middle Name:JIMENEZ
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, NCC, LPC
Mailing Address - Street 1:305 N HEATHERWILDE BLVD
Mailing Address - Street 2:STE. 310
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-3757
Mailing Address - Country:US
Mailing Address - Phone:512-704-8349
Mailing Address - Fax:
Practice Address - Street 1:305 N HEATHERWILDE BLVD
Practice Address - Street 2:STE. 310
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-3757
Practice Address - Country:US
Practice Address - Phone:512-704-8349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-12
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68770101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional