Provider Demographics
NPI:1841993227
Name:CAUSEY, JACQUES NICOLE (LPC)
Entity type:Individual
Prefix:
First Name:JACQUES
Middle Name:NICOLE
Last Name:CAUSEY
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 1:9952 WESTWOOD MANOR DR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38139-5534
Mailing Address - Country:US
Mailing Address - Phone:901-340-2871
Mailing Address - Fax:
Practice Address - Street 1:752 WALNUT KNOLL LN STE 201
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-3111
Practice Address - Country:US
Practice Address - Phone:901-340-2871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-23
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6383101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health