Provider Demographics
NPI:1043544752
Name:GARNER, JENNY LEA (LPC SUPERVISOR)
Entity type:Individual
Prefix:PROF
First Name:JENNY
Middle Name:LEA
Last Name:GARNER
Suffix:
Gender:F
Credentials:LPC SUPERVISOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:864 COUNTY ROAD 4850
Mailing Address - Street 2:
Mailing Address - City:LEONARD
Mailing Address - State:TX
Mailing Address - Zip Code:75452-3111
Mailing Address - Country:US
Mailing Address - Phone:214-668-4287
Mailing Address - Fax:
Practice Address - Street 1:864 COUNTY ROAD 4850
Practice Address - Street 2:
Practice Address - City:LEONARD
Practice Address - State:TX
Practice Address - Zip Code:75452-3111
Practice Address - Country:US
Practice Address - Phone:214-668-4287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-28
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65826101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX65826OtherLPC SUPERVISOR