Provider Demographics
NPI:1316402340
Name:PADILLA, JENNIFER LAUREN (LCMHC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LAUREN
Last Name:PADILLA
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-4120
Mailing Address - Country:US
Mailing Address - Phone:480-252-8281
Mailing Address - Fax:
Practice Address - Street 1:12 1/2 WALL ST STE S2
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-2724
Practice Address - Country:US
Practice Address - Phone:480-252-8281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-04
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17210101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional