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NPI 1285990820

NPI 1285990820 : JENNIFER E. EULBERG MA, LPC : SAINT CHARLES, MO

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General NPI Number Information
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    NPI Number           |    1285990820
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    Entity Type          |    Individual 
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    Provider Name        |    JENNIFER E. EULBERG MA, LPC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/09/2012
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    Last Update Date     |    01/03/2023
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Provider Practice Location Address
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    Address Line         |    2451 EXECUTIVE DR STE 205 
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    City                 |    SAINT CHARLES
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    State                |    MO
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    Zip                  |    63303-5606
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    Country              |    US
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    Telephone            |    636-299-0780
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2451 EXECUTIVE DR STE 205 
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    City                 |    SAINT CHARLES
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    State                |    MO
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    Zip                  |    63303-5606
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    Country              |    US
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    Telephone            |    636-299-0780
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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        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    2016031465
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    License Number State |    MO
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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       |    2016031465
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    License Number State |    MO
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