Provider Demographics
NPI:1033461629
Name:PALAHNIUK, JENNIFER LYN (LCSW)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYN
Last Name:PALAHNIUK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6334 FM 2920 RD STE 300
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-3473
Mailing Address - Country:US
Mailing Address - Phone:281-370-0616
Mailing Address - Fax:281-370-0609
Practice Address - Street 1:6334 FM 2920 RD STE 300
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-3473
Practice Address - Country:US
Practice Address - Phone:832-828-3322
Practice Address - Fax:281-370-0690
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-08
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX662821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical