Provider Demographics
NPI:1548639131
Name:STEPHENS, JENNIFER GATLIN (LPC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:GATLIN
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 FOX ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:AL
Mailing Address - Zip Code:36352-8058
Mailing Address - Country:US
Mailing Address - Phone:334-798-4365
Mailing Address - Fax:
Practice Address - Street 1:74 FOX ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:AL
Practice Address - Zip Code:36352-8058
Practice Address - Country:US
Practice Address - Phone:334-798-4365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-24
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
AL3453101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional