Provider Demographics
NPI:1730233248
Name:JOLIVETTE, JENNY ELIE (MA, LPC)
Entity type:Individual
Prefix:MRS
First Name:JENNY
Middle Name:ELIE
Last Name:JOLIVETTE
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2335 GENTRYSIDE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-5522
Mailing Address - Country:US
Mailing Address - Phone:281-734-7409
Mailing Address - Fax:281-584-9905
Practice Address - Street 1:2825 WILCREST DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-3391
Practice Address - Country:US
Practice Address - Phone:281-734-7409
Practice Address - Fax:281-584-9905
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17751101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX549442OtherVALUE OPTIONS