Provider Demographics
NPI:1043545700
Name:SCHALOW, JENNIFER (LPC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:SCHALOW
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 TINY TOWN AVE
Mailing Address - Street 2:STE B #2021
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37042-7660
Mailing Address - Country:US
Mailing Address - Phone:501-318-3760
Mailing Address - Fax:
Practice Address - Street 1:919 TINY TOWN AVE
Practice Address - Street 2:STE B #2021
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37042-7660
Practice Address - Country:US
Practice Address - Phone:501-318-3760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-13
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1809131101YM0800X
VA0701010284101YP2500X
TN7418101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional