Provider Demographics
NPI:1699070128
Name:CHRISMAN, JENNIFER A (LCPC)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:A
Last Name:CHRISMAN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 E MAIN ST STE 407
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-4731
Mailing Address - Country:US
Mailing Address - Phone:406-570-3717
Mailing Address - Fax:
Practice Address - Street 1:321 E MAIN ST STE 407
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-4731
Practice Address - Country:US
Practice Address - Phone:406-570-3717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-13
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1437 LCPC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health