Provider Demographics
NPI:1063818961
Name:JENA D MCNAMAR, MAMFT, LPC, PLLC
Entity type:Organization
Organization Name:JENA D MCNAMAR, MAMFT, LPC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENA
Authorized Official - Middle Name:D
Authorized Official - Last Name:MCNAMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MAMFT, LPC, PLLC
Authorized Official - Phone:405-641-7905
Mailing Address - Street 1:2216 SHADOWLAKE DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73159-7440
Mailing Address - Country:US
Mailing Address - Phone:405-641-7905
Mailing Address - Fax:405-735-6760
Practice Address - Street 1:2216 SHADOWLAKE DR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-7440
Practice Address - Country:US
Practice Address - Phone:405-641-7905
Practice Address - Fax:405-735-6760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-05
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5022101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty