Edmondson, Jennifer Erin

Edmondson, Jennifer Erin is an sole proprietor health care provider with primary practice located at 1601 S State St Ste 100 , Edmond OK 73013-3507. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Behavioral Analyst, Behavioral Health & Social Service Providers / Counselor. Behavioral Health & Social Service Providers / Counselor is her primary health care specialty. Edmondson, Jennifer Erin can be contacted via phone (405) 315-7093.

Contact Information

Primary practice address
1601 S State St Ste 100 Edmond OK 73013-3507
Phone: (405) 315-7093
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 1067 Oklahoma
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X
Behavioral Health & Social Service Providers / Counselor 101Y00000X 5028 Oklahoma

Profile Details

NPI number 1033404876
LBN Legal business name Edmondson, Jennifer Erin
Credentials LPC, LADC, CMIII
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 9th, 2011
Last updated Jun 11th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033404876 NPPES
Oklahoma MEDICAID 200370610B

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