Provider Demographics
NPI:1710876867
Name:VAHSHOLTZ, JENNIFER KERNER (LPC)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:KERNER
Last Name:VAHSHOLTZ
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 1:12419 S ABBOTT DOWNING WAY
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-5672
Mailing Address - Country:US
Mailing Address - Phone:208-249-5773
Mailing Address - Fax:
Practice Address - Street 1:4286 E AMITY AVE
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83687-8175
Practice Address - Country:US
Practice Address - Phone:208-249-5773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID2071668101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health