Healthcare Provider Details

I. General information

NPI: 1033861976
Provider Name (Legal Business Name): JENNIFER DOVER LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/21/2022
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

177 NORTHLAND DR
MEDINA OH
44256-1534
US

IV. Provider business mailing address

4027 BARRINGTON DR
MEDINA OH
44256-5954
US

V. Phone/Fax

Practice location:
  • Phone: 216-340-2882
  • Fax:
Mailing address:
  • Phone: 440-309-8961
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.2607422
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: