Provider Demographics
NPI:1366579799
Name:TAUSSIG, JENNIFER (LMSW)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:TAUSSIG
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 547
Mailing Address - Street 2:
Mailing Address - City:BRADFORD
Mailing Address - State:AR
Mailing Address - Zip Code:72020-0547
Mailing Address - Country:US
Mailing Address - Phone:870-793-3334
Mailing Address - Fax:870-793-3474
Practice Address - Street 1:2040 FITZHUGH ST
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-7409
Practice Address - Country:US
Practice Address - Phone:870-793-3334
Practice Address - Fax:870-793-3474
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1838-M1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical