MEDICARE: JENNIFER VOLLMER 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	101YM0800X	Mental Health Counselor	6401222453	MI

General Provider Information

NPI Number	:	1346996022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER VOLLMER LPC

Provider Business Mailing Address
First Line	:	PO BOX 561
Second Line	:
City	:	CHARLEVOIX
State	:	MI
Zip	:	49720-0561
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	221 BRIDGE ST UNIT 1
Second Line	:
City	:	CHARLEVOIX
State	:	MI
Zip	:	49720-1400
Country	:	US
Telephone Number	:	231-675-3925
Fax Number	:

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

Provider Enumeration Date	:	02/22/2022
Last Update Date	:	02/22/2022

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