Provider Demographics
NPI:1437991767
Name:JENNIFER PUTT GROUP, PLLC
Entity type:Organization
Organization Name:JENNIFER PUTT GROUP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:PUTT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:984-332-9631
Mailing Address - Street 1:101 AVENT MEADOWS LN
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-7063
Mailing Address - Country:US
Mailing Address - Phone:805-660-7175
Mailing Address - Fax:
Practice Address - Street 1:113 HOLLY SPRINGS RD STE 202
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-9423
Practice Address - Country:US
Practice Address - Phone:805-660-7175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty