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General NPI Number Information
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NPI Number | 1972063451
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Entity Type | Individual
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Provider Name | JENNIFER LINVILLE LPCC
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Gender | Female
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Dates
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Enumeration Date | 03/21/2019
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Last Update Date | 02/24/2023
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Provider Practice Location Address
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Address Line | 2138 BROADWAY ST
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City | PADUCAH
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State | KY
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Zip | 42001-7110
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Country | US
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Telephone | 270-449-1541
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Fax |
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Provider Business Mailing Address
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Address Line | 252 N 38TH ST
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City | PADUCAH
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State | KY
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Zip | 42001-4721
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Country | US
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Telephone | 270-449-1451
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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 | 247435
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License Number State | KY
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