Jennifer Lynn Dougherty, PH.D.

Primary specialty

CounselorTaxonomy code 101Y00000X

License

20192 Issued in TX

Practice address

17103 Preston Rd
Suite 288
Dallas, TX 75248-1332

Phone

(469) 251-0803

NPI assigned

Oct 2, 2009

Last updated

Jan 29, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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.

• Dallas New Leaf Clinic

  • Mental Health Counselor
  • Dallas, TX
  • NPI 1043600596
  NPD (past) Authorized official

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

{
    "created_epoch": "1254441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422489600000",
    "number": "1669707097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17103 PRESTON RD",
            "address_2": "SUITE 288",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752481332",
            "telephone_number": "469-251-0803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17103 PRESTON RD",
            "address_2": "SUITE 288",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752481332",
            "telephone_number": "469-251-0803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-02",
        "last_updated": "2015-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "20192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheila Allison Dougan, APRN, FNP-BC
• Crystal Jenise Dougher, B.A.
• Alleyna Dougherty, MD
• Amie Lynn Boles Dougherty, PT, DPT
• Doug Michael Dougherty, THM MED LPC
• Michael Dougherty
• Mitchell Reid Dougherty, DC
• Patrick Kelly Dougherty, MPAS, PA-C
• Dougherty's Pharmacy Inc. (dba Dougherty's Home Care Pharmacy)
• Doughertys LTC Pharmacy LLC (Dougherty's LTC Pharmacy)

• Counselor in Dallas, TX
• Providers in Dallas, TX by specialty
• Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2015; 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.