Provider Demographics
NPI:1992078430
Name:JENNY JACOBS COUNSELING, PLLC
Entity type:Organization
Organization Name:JENNY JACOBS COUNSELING, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:H
Authorized Official - Last Name:JACOBS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:713-364-8032
Mailing Address - Street 1:5610 RAPID BROOK CT
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77345-1922
Mailing Address - Country:US
Mailing Address - Phone:713-364-8032
Mailing Address - Fax:832-442-3012
Practice Address - Street 1:4439 TOWN CENTER PL
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-3714
Practice Address - Country:US
Practice Address - Phone:713-364-8032
Practice Address - Fax:832-442-3012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-14
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64668101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2832388Medicaid