Provider Demographics
NPI:1194483016
Name:HORTON, JENNIFER ANN (LCPC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANN
Last Name:HORTON
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 1:10812 ANDREA DR
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-8441
Mailing Address - Country:US
Mailing Address - Phone:708-833-0365
Mailing Address - Fax:
Practice Address - Street 1:3329 75TH STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:WOODRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60517
Practice Address - Country:US
Practice Address - Phone:630-305-5118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-08
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.013959101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health