Healthcare Provider Details

I. General information

NPI: 1073079836
Provider Name (Legal Business Name): JENNIFER ANN GOLIGHTLY LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2019
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9730 WESTOVER HILLS BLVD STE 108
SAN ANTONIO TX
78251-4842
US

IV. Provider business mailing address

6800 PARK TEN BLVD STE 200S
SAN ANTONIO TX
78213-4293
US

V. Phone/Fax

Practice location:
  • Phone: 210-366-3700
  • Fax:
Mailing address:
  • Phone: 210-261-1000
  • Fax: 210-261-1821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number79163
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number79163
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: