| Doctor Name: | MRS. JEANNIE LYNN WARREN |
| NPI Number: | 1194894048 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCPC |
| License Number: | 180005092 |
| Business Practice Address: | 20 A Professional Park Drive Maryville, IL - 62062 |
| Business Phone Number: | 6182888787 |
| Business Fax Number: | 6182880737 |
| Mailing Address: | 643 Tamarach, EDWARDSBILLE |
| State: | IL |
| Postal Code: | 620255250 |
| Phone Number: | 6184448761 |
| Fax Number: | 6186379030 |
| NPI Enumeration Date: | 11/07/2006 |
| NPI Last Update Date: | 05/19/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | 180005092 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |