Provider Demographics
NPI:1902091648
Name:HATTAN, JENNY ELIZABETH (LPC, LCASA)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:ELIZABETH
Last Name:HATTAN
Suffix:
Gender:F
Credentials:LPC, LCASA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210A HAIGH ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28312-5386
Mailing Address - Country:US
Mailing Address - Phone:336-675-7675
Mailing Address - Fax:336-675-7675
Practice Address - Street 1:210A HAIGH ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28312-5386
Practice Address - Country:US
Practice Address - Phone:336-675-7675
Practice Address - Fax:336-675-7675
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-06
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3003A101YA0400X
NC9989101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)