Provider Demographics
NPI:1699861989
Name:LAGROTTE, JENNIFER B (LMHC, LMFT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:B
Last Name:LAGROTTE
Suffix:
Gender:F
Credentials:LMHC, LMFT
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:B
Other - Last Name:LAGROTTE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT, LMFT
Mailing Address - Street 1:11555 HERON BAY BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33076-3362
Mailing Address - Country:US
Mailing Address - Phone:954-840-3249
Mailing Address - Fax:
Practice Address - Street 1:11555 HERON BAY BLVD STE 200
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33076-3362
Practice Address - Country:US
Practice Address - Phone:954-840-3249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
FLMH7309101YM0800X
FLMT1998106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health