Provider Demographics
NPI:1851527097
Name:KLATKA, JENNIFER ANNE (LPCC-SUPV)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANNE
Last Name:KLATKA
Suffix:
Gender:
Credentials:LPCC-SUPV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 N SCOTTSDALE RD STE 2500
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-7630
Mailing Address - Country:US
Mailing Address - Phone:843-501-1099
Mailing Address - Fax:843-405-2040
Practice Address - Street 1:1422 ASHLEY RIVER RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-5306
Practice Address - Country:US
Practice Address - Phone:843-501-1099
Practice Address - Fax:843-405-2040
Is Sole Proprietor?:No
Enumeration Date:2009-06-02
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE-0008425-SUPV101YP2500X
OHE-0008425101YP2500X
SC9770101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional