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General NPI Number Information
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NPI Number | 1417952409
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Entity Type | Individual
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Provider Name | JEANIE HANCOCK M.ED., LPC
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Gender | Female
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Dates
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Enumeration Date | 06/16/2005
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 115 S TRAVIS ST
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City | SHERMAN
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State | TX
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Zip | 75090-5990
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Country | US
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Telephone | 903-891-8687
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Fax | 903-892-4934
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Provider Business Mailing Address
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Address Line | 710 LEGEND LN
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City | SHERMAN
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State | TX
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Zip | 75092-5421
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Country | US
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Telephone | 903-891-8687
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Fax | 903-892-4934
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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 | 16689
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License Number State | TX
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