Deacon, Jennifer M.

Deacon, Jennifer M. is an individual health care provider with primary practice located at 512 Riverside Dr , Morganton NC 28655-3727. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavioral Analyst, Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities. Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities is her primary health care specialty. Deacon, Jennifer M. can be contacted via phone (828) 403-3353.

Contact Information

Primary practice address
512 Riverside Dr Morganton NC 28655-3727
Phone: (828) 403-3353
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 1-12-12257 North Carolina
Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities 103TM1800X 1982 North Carolina

Profile Details

NPI number 1063697118
LBN Legal business name Deacon, Jennifer M.
Credentials PSYCH. ASSOCIATE
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 8th, 2008
Last updated Jul 5th, 2021 - about 4 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 1063697118 NPPES
North Carolina MEDICAID 6107547

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