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Jennifer Dawn Wallace, LPCC/S
Counselor in Georgetown, Kentucky
NPI 1174158976

Jennifer Dawn Wallace is a Counselor based in Georgetown, KY. Jennifer Dawn Wallace practices in Georgetown, KY and has the professional credentials of LPCC/S. The NPI Number for Jennifer Dawn Wallace is 1174158976 and holds a License No. 104157 (Kentucky).

The current practice location address for Jennifer Dawn Wallace is 204 Bevins Ln Ste A, Georgetown, KY and can be reached out via phone at 859-951-9777 and via fax at 859-951-9779. You can also correspond with Jennifer Dawn Wallace through the mailing address at 204 BEVINS LN STE A, GEORGETOWN, KY - 40324-6145 (mailing address contact number: 859-951-9777).

Location: 204 Bevins Ln Ste A, Georgetown, KY, 40324-6145
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1174158976
Provider Name
Jennifer Dawn Wallace
Credential
LPCC/S
Provider Entity Type
Individual
Gender
Female
Address
204 Bevins Ln Ste A, Georgetown, KY, 40324-6145
Phone Number
859-951-9777
Fax Number
859-951-9779
Provider Enumeration Date
03/12/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
204 Bevins Ln Ste A
City
Georgetown
State
Kentucky
Zip
40324-6145
Phone Number
859-951-9777
Fax Number
859-951-9779
person
Provider Business Mailing Address Details
Address
204 Bevins Ln Ste A
City
Georgetown
State
Kentucky
Zip
40324-6145
Phone Number
859-951-9777
Fax Number
859-951-9779
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
104157 (Kentucky)
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
101YP2500X
License No.
104157 ()
Definition
Definition to come...
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