Provider Demographics
NPI:1316269566
Name:FALBO-NEGRON, JENNIFER ANN (MA, ED S, LCPC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANN
Last Name:FALBO-NEGRON
Suffix:
Gender:
Credentials:MA, ED S, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 N RANDALL RD STE 21
Mailing Address - Street 2:
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-1500
Mailing Address - Country:US
Mailing Address - Phone:630-526-4325
Mailing Address - Fax:
Practice Address - Street 1:333 N RANDALL RD STE 21
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-1500
Practice Address - Country:US
Practice Address - Phone:630-526-4325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-15
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1864784103TS0200X
IL180.007865101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool