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General NPI Number Information
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NPI Number | 1083879977
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Entity Type | Individual
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Provider Name | JENNIFER JANEL COURREGES M.S., LPC
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Gender | Female
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Dates
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Enumeration Date | 07/21/2008
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Last Update Date | 08/27/2019
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Provider Practice Location Address
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Address Line | 12600 HILL COUNTRY BLVD STE R-275
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City | BEE CAVE
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State | TX
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Zip | 78738-6768
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Country | US
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Telephone | 512-484-7111
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Fax |
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Provider Business Mailing Address
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Address Line | 18612 WHEELOCK CT
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City | AUSTIN
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State | TX
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Zip | 78738-4157
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Country | US
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Telephone | 512-484-7111
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701004358
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 80130
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License Number State | TX
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