Provider Demographics
NPI:1396268876
Name:REED, JENNIFER ELAINE (MS, LPC)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ELAINE
Last Name:REED
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5930 VANDERBILT AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-6136
Mailing Address - Country:US
Mailing Address - Phone:469-258-6525
Mailing Address - Fax:
Practice Address - Street 1:9941 LINGO LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75228-3349
Practice Address - Country:US
Practice Address - Phone:972-502-4107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-17
Last Update Date:2017-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69275101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional