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:
Health care specialties
Specialty | Code | License # | 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 3 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1063697118 | NPPES |
North Carolina | MEDICAID | 6107547 |
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