MEDICARE: MRS. JENIFER NICHELE JAMES LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	6401016546	MI
2	101YP2500X	Professional Counselor
3	247200000X	Other Technician
4	101YP2500X	Professional Counselor	87199	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114370871
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENIFER NICHELE JAMES LPC

Provider Business Mailing Address
First Line	:	24385 WILDERNESS OAK APT 8402
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-7766
Country	:	US
Telephone Number	:	517-505-6424
Fax Number	:

Provider Business Practice Location Address
First Line	:	645 N WALNUT AVE
Second Line	:
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78130-7925
Country	:	US
Telephone Number	:	830-730-6090
Fax Number	:	830-455-4355

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2016
Last Update Date	:	04/03/2023

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