Provider Demographics
NPI:1912493966
Name:SEWELL, JENNIFER WORTHINGTON (LPC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:WORTHINGTON
Last Name:SEWELL
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 1:4146 CARMICHAEL CT
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-2871
Mailing Address - Country:US
Mailing Address - Phone:334-409-0210
Mailing Address - Fax:334-409-0250
Practice Address - Street 1:4146 CARMICHAEL CT
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-2871
Practice Address - Country:US
Practice Address - Phone:334-409-0210
Practice Address - Fax:334-409-0250
Is Sole Proprietor?:No
Enumeration Date:2018-07-02
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3331101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional