Provider Demographics
NPI:1770973422
Name:DANOS, JENNIFER CANNATELLA (LPC)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:CANNATELLA
Last Name:DANOS
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 1:1340 W TUNNEL BLVD STE 317
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-2861
Mailing Address - Country:US
Mailing Address - Phone:985-876-4480
Mailing Address - Fax:985-385-9889
Practice Address - Street 1:1340 W TUNNEL BLVD STE 317
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-2861
Practice Address - Country:US
Practice Address - Phone:985-876-4480
Practice Address - Fax:985-385-9889
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-03
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5513101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional