Provider Demographics
NPI:1104272699
Name:OEFFINGER, JASANDRA LOURDES (LPC)
Entity type:Individual
Prefix:MS
First Name:JASANDRA
Middle Name:LOURDES
Last Name:OEFFINGER
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 1:627 W 19TH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-3658
Mailing Address - Country:US
Mailing Address - Phone:713-268-0979
Mailing Address - Fax:
Practice Address - Street 1:627 W 19TH ST STE 201
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-3658
Practice Address - Country:US
Practice Address - Phone:713-268-0979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-13
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX72881101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX72881OtherLICENSED PROFESSIONAL COUNSELOR