Provider Demographics
NPI:1225361397
Name:GINGER, CLARISSA JONES (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:CLARISSA
Middle Name:JONES
Last Name:GINGER
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 W MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272-1829
Mailing Address - Country:US
Mailing Address - Phone:425-418-7032
Mailing Address - Fax:
Practice Address - Street 1:204 W MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-1829
Practice Address - Country:US
Practice Address - Phone:425-418-7032
Practice Address - Fax:360-863-6110
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-08
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60359984101YM0800X
WAMC60181652101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health