Provider Demographics
NPI:1780175265
Name:ACKERMAN, JENNIFER LAUREN (MS, LMFT-A, LPC-I)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LAUREN
Last Name:ACKERMAN
Suffix:
Gender:F
Credentials:MS, LMFT-A, LPC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 MARLIN ST
Mailing Address - Street 2:
Mailing Address - City:BAYOU VISTA
Mailing Address - State:TX
Mailing Address - Zip Code:77563-2614
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:303 E MAIN ST # 235
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-3742
Practice Address - Country:US
Practice Address - Phone:281-944-8218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-21
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX202764101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health