Jennifer M Huddleston, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC005784 Issued in GA

Practice address

165 Bradford SQ Ste D
Fayetteville, GA 30215-1960

Phone

(678) 410-6874

NPI assigned

Apr 4, 2007

Last updated

Jul 17, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Ms. Jennifer Ellen Morris Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• McIntosh Trail Community Service Board

  • Community/Behavioral Health Agency
  • Griffin, GA
  • NPI 1336317270
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1285756668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 BRADFORD SQ STE D",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302151960",
            "telephone_number": "678-410-6874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 BRADFORD SQ STE D",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302151960",
            "telephone_number": "678-410-6874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDDLESTON",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "APC001502",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC005784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "MORRIS",
            "middle_name": "ELLEN",
            "prefix": "MS.",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hospice Advantage, LLC. (Compassus - Fayetteville)
• Aleese Howard, RBT
• Douglas E Howell, MD
• Michele Howell
• Ruth Howell, LPC
• Walter Kenneth Hudson, DMD
• Katie Huggins
• Colette Hughes
• Barry Kenton Hull, M.D.
• Human Services Management Group, Inc.

• Professional Counselor in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.