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General NPI Number Information
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NPI Number | 1265138838
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Entity Type | Individual
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Provider Name | JENNIFER LYN RAYMOND LPC
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Gender | Female
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Dates
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Enumeration Date | 02/06/2023
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 500 BROWN BLVD
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City | BOURBONNAIS
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State | IL
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Zip | 60914-2328
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Country | US
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Telephone | 815-214-9766
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Fax |
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Provider Business Mailing Address
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Address Line | 8023 HARRIER AVE
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City | JOLIET
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State | IL
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Zip | 60431-7050
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Country | US
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Telephone | 815-523-6603
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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 | 178018869
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License Number State | IL
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