Provider Demographics
NPI:1487410809
Name:JENNIFER DOUGHER LPC LLC
Entity type:Organization
Organization Name:JENNIFER DOUGHER LPC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LPC
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:DOUGHER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:717-850-3539
Mailing Address - Street 1:1017 MUMMA RD STE 202
Mailing Address - Street 2:
Mailing Address - City:WORMLEYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17043-1145
Mailing Address - Country:US
Mailing Address - Phone:717-850-3539
Mailing Address - Fax:
Practice Address - Street 1:1017 MUMMA RD STE 202
Practice Address - Street 2:
Practice Address - City:WORMLEYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17043-1145
Practice Address - Country:US
Practice Address - Phone:717-850-3539
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-23
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty