Provider Demographics
NPI:1548712052
Name:HOPPER, JEANA RENEA (LPC)
Entity type:Individual
Prefix:
First Name:JEANA
Middle Name:RENEA
Last Name:HOPPER
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 1:4611 ROGERS AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-3137
Mailing Address - Country:US
Mailing Address - Phone:479-322-9273
Mailing Address - Fax:
Practice Address - Street 1:4951 OLD GREENWOOD RD
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-6906
Practice Address - Country:US
Practice Address - Phone:479-709-9880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-01
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1702238101YM0800X
ARA1502034101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health