Provider Demographics
NPI:1730780644
Name:PRITCHETT, JEANNA (MA)
Entity type:Individual
Prefix:
First Name:JEANNA
Middle Name:
Last Name:PRITCHETT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1822 PERRY CT
Mailing Address - Street 2:
Mailing Address - City:SYCAMORE
Mailing Address - State:IL
Mailing Address - Zip Code:60178-3016
Mailing Address - Country:US
Mailing Address - Phone:630-276-3178
Mailing Address - Fax:
Practice Address - Street 1:1250 EXECUTIVE PL STE 201
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-3805
Practice Address - Country:US
Practice Address - Phone:815-223-2237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-06
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-23-68261103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst