Provider Demographics
NPI:1154502391
Name:FEENEY, JOLENE MARIE (NCC, CDP, LMHC)
Entity Type:Individual
Prefix:MRS
First Name:JOLENE
Middle Name:MARIE
Last Name:FEENEY
Suffix:
Gender:F
Credentials:NCC, CDP, LMHC
Other - Prefix:MISS
Other - First Name:JOLENE
Other - Middle Name:MARIE
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:815 E 28TH ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98663-3026
Mailing Address - Country:US
Mailing Address - Phone:406-531-4105
Mailing Address - Fax:
Practice Address - Street 1:10000 NE 7TH AVE
Practice Address - Street 2:SUITE 215
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98685-4599
Practice Address - Country:US
Practice Address - Phone:360-574-9565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-15
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT390200000X
WALH 60429987101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program