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General NPI Number Information
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NPI Number | 1194602581
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Entity Type | Organization
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Legal Business Name | JEN WOODRUM COUNSELING PLLC
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Dates
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Enumeration Date | 08/19/2025
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Last Update Date | 12/13/2025
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Provider Practice Location Address
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Address Line | 2103 E WASHINGTON ST STE 3E
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City | BLOOMINGTON
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State | IL
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Zip | 61701-4365
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Country | US
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Telephone | 309-271-7042
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Fax | 309-322-8894
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Provider Business Mailing Address
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Address Line | 2103 E WASHINGTON ST STE 3E
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City | BLOOMINGTON
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State | IL
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Zip | 61701-4365
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Country | US
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Telephone | 309-271-7042
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Fax | 309-322-8894
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Authorized Official
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Title or Position | THERAPIST
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Name | JENNIFER WOODRUM
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Credential | MS, LCPC
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Telephone | 224-217-0151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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