Jennie Elise McMillian, LPC, MA

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC 12138 Issued in AZ

Practice address

590 S Ocotillo Ave
Benson, AZ 85602-6405

Phone

(520) 586-7080

Fax

(520) 586-3163

NPI assigned

Dec 15, 2006

Last updated

Jul 8, 2007By 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

Other names 1

• Jennie Elise Weitekamp Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902968845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "489 N ARROYO BLVD",
            "city": "NOGALES",
            "state": "AZ",
            "postal_code": "856212644",
            "telephone_number": "520-287-4713",
            "fax_number": "520-287-9794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 S OCOTILLO AVE",
            "city": "BENSON",
            "state": "AZ",
            "postal_code": "856026405",
            "telephone_number": "520-586-7080",
            "fax_number": "520-586-3163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMILLIAN",
        "first_name": "JENNIE",
        "middle_name": "ELISE",
        "credential": "LPC, MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC 12138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIE",
            "last_name": "WEITEKAMP",
            "middle_name": "ELISE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Nes Arizona Inc

• Professional Counselor in Benson, AZ
• Providers in Benson, AZ by specialty
• Professional Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.