Provider Demographics
NPI:1427648237
Name:COOK, JENNA (LPC)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:COOK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 EDGE VIEW LN
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-1883
Mailing Address - Country:US
Mailing Address - Phone:409-960-1273
Mailing Address - Fax:
Practice Address - Street 1:4130 BELLAIRE BLVD STE 208
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-1056
Practice Address - Country:US
Practice Address - Phone:713-993-7030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-25
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81354101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty