Provider Demographics
NPI:1093544041
Name:NEVE, JENNA (LCPC)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:NEVE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 321
Mailing Address - Street 2:
Mailing Address - City:HERON
Mailing Address - State:MT
Mailing Address - Zip Code:59844-0321
Mailing Address - Country:US
Mailing Address - Phone:802-345-0585
Mailing Address - Fax:
Practice Address - Street 1:63 HUGH LILLARD LN
Practice Address - Street 2:
Practice Address - City:HERON
Practice Address - State:MT
Practice Address - Zip Code:59844-9583
Practice Address - Country:US
Practice Address - Phone:802-345-0585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID10428101YM0800X
MT70218101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health