Healthcare Provider Details

I. General information

NPI: 1023921269
Provider Name (Legal Business Name): JENNIFER LATOYA CHAVEZ LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 CLAYTON STREET
DENTON TX
77535
US

IV. Provider business mailing address

3555 PATCH RD
SAN ANTONIO TX
78234-1200
US

V. Phone/Fax

Practice location:
  • Phone: 346-219-9946
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number94733
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: