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General NPI Number Information
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NPI Number | 1396099198
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Entity Type | Individual
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Provider Name | JENNIFER KATHLEEN PHILLIPS LPC
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Gender | Female
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Dates
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Enumeration Date | 10/31/2012
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Last Update Date | 10/31/2012
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Provider Practice Location Address
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Address Line | 1000 VETERANS MEMORIAL BLVD STE 305
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City | METAIRIE
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State | LA
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Zip | 70005-2852
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Country | US
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Telephone | 504-355-6107
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Fax |
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Provider Business Mailing Address
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Address Line | 213 AMELIA ST
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City | DESTREHAN
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State | LA
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Zip | 70047-5349
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Country | US
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Telephone | 504-355-6107
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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 | 5163
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License Number State | LA
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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 | 1554
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License Number State | MS
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