Healthcare Provider Details

I. General information

NPI: 1134745342
Provider Name (Legal Business Name): JENNIFER YEAGER LPC, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2020
Last Update Date: 05/13/2021
Certification Date: 05/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 N COLLINS BLVD STE 126
RICHARDSON TX
75080-3554
US

IV. Provider business mailing address

325 TURTLE CREEK DR
MCKINNEY TX
75072-7173
US

V. Phone/Fax

Practice location:
  • Phone: 214-791-1902
  • Fax:
Mailing address:
  • Phone: 214-418-7661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number203091
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number78951
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: