Provider Demographics
NPI:1871357103
Name:PRICHARD, JENN MCCARTHY-BLUNDIN (LMFT-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:JENN
Middle Name:MCCARTHY-BLUNDIN
Last Name:PRICHARD
Suffix:
Gender:F
Credentials:LMFT-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 HILL CIR
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:TX
Mailing Address - Zip Code:79553-6910
Mailing Address - Country:US
Mailing Address - Phone:325-518-6256
Mailing Address - Fax:
Practice Address - Street 1:520 HILL CIR
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:TX
Practice Address - Zip Code:79553-6910
Practice Address - Country:US
Practice Address - Phone:325-518-6256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX205173106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist