Provider Demographics
NPI:1487965521
Name:DOWNEY-RUTLEDGE, JENNIFER RENAE (MS, LPC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:RENAE
Last Name:DOWNEY-RUTLEDGE
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:RENAE
Other - Last Name:DOWNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20 SUN VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:CABOT
Mailing Address - State:AR
Mailing Address - Zip Code:72023-2056
Mailing Address - Country:US
Mailing Address - Phone:501-231-5544
Mailing Address - Fax:
Practice Address - Street 1:12406 HIGHWAY 5 STE C
Practice Address - Street 2:
Practice Address - City:CABOT
Practice Address - State:AR
Practice Address - Zip Code:72023-7657
Practice Address - Country:US
Practice Address - Phone:501-231-5544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-23
Last Update Date:2022-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP2206011101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional