Provider Demographics
NPI:1942502430
Name:ALLEN, JENNIFER GAYLE (MS, LPC)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:GAYLE
Last Name:ALLEN
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:339757 E 890 RD
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:OK
Mailing Address - Zip Code:74834-7066
Mailing Address - Country:US
Mailing Address - Phone:405-986-0173
Mailing Address - Fax:
Practice Address - Street 1:12617 S MCLOUD RD
Practice Address - Street 2:
Practice Address - City:MCLOUD
Practice Address - State:OK
Practice Address - Zip Code:74851-8509
Practice Address - Country:US
Practice Address - Phone:405-986-0173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-03
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6136101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health