Provider Demographics
NPI:1386717650
Name:PANFELD, JEANIE (LMSW)
Entity type:Individual
Prefix:
First Name:JEANIE
Middle Name:
Last Name:PANFELD
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 781013
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78278-1013
Mailing Address - Country:US
Mailing Address - Phone:210-240-9389
Mailing Address - Fax:
Practice Address - Street 1:102 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:CONVERSE
Practice Address - State:TX
Practice Address - Zip Code:78109-1320
Practice Address - Country:US
Practice Address - Phone:210-945-1260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLMSW 264531041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool