Provider Demographics
NPI:1871878736
Name:WATGEN, JENNIFER M (MA, NCC, LCPC)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:M
Last Name:WATGEN
Suffix:
Gender:F
Credentials:MA, NCC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 N LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:IL
Mailing Address - Zip Code:60510-1912
Mailing Address - Country:US
Mailing Address - Phone:630-879-1091
Mailing Address - Fax:630-879-1096
Practice Address - Street 1:500 E OGDEN AVE STE 207
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-3492
Practice Address - Country:US
Practice Address - Phone:630-416-1090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-11
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.007819101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional