Provider Demographics
NPI:1124504816
Name:DAY, JENNIFER C (MED LPC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:C
Last Name:DAY
Suffix:
Gender:F
Credentials:MED LPC
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:C
Other - Last Name:DAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MED LPC
Mailing Address - Street 1:4940 KNIGHT DR
Mailing Address - Street 2:
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791-2500
Mailing Address - Country:US
Mailing Address - Phone:225-301-7900
Mailing Address - Fax:
Practice Address - Street 1:522 N NEW HAMPSHIRE ST STE 8
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-2843
Practice Address - Country:US
Practice Address - Phone:225-307-3520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-16
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5422101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health