Provider Demographics
NPI:1902111966
Name:EMERSON, JENNY (MMFT, LMT)
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:
Last Name:EMERSON
Suffix:
Gender:F
Credentials:MMFT, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1711 19TH AVE S
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212-3701
Mailing Address - Country:US
Mailing Address - Phone:615-476-0996
Mailing Address - Fax:615-383-4473
Practice Address - Street 1:1711 19TH AVE S
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-3701
Practice Address - Country:US
Practice Address - Phone:615-476-0996
Practice Address - Fax:615-383-4473
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-15
Last Update Date:2010-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN882106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist