Provider Demographics
NPI:1720808678
Name:PACHECO ECHAVARRIA, JHENNIFER (LMSW)
Entity type:Individual
Prefix:
First Name:JHENNIFER
Middle Name:
Last Name:PACHECO ECHAVARRIA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:626 EAST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70802-6011
Mailing Address - Country:US
Mailing Address - Phone:225-343-1984
Mailing Address - Fax:
Practice Address - Street 1:646 EAST BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70802-6011
Practice Address - Country:US
Practice Address - Phone:225-910-4476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA18100104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker