Provider Demographics
NPI:1326397043
Name:CONNORS, JENNIFER LYNETTE (AAC, LMHC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNETTE
Last Name:CONNORS
Suffix:
Gender:F
Credentials:AAC, LMHC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LYNETTE
Other - Last Name:DEFORGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1600 E OLIVE ST
Mailing Address - Street 2:SOUND MENTAL HEALTH
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-2735
Mailing Address - Country:US
Mailing Address - Phone:206-302-2200
Mailing Address - Fax:206-302-2210
Practice Address - Street 1:1600 E OLIVE ST
Practice Address - Street 2:SOUND MENTAL HEALTH
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-2735
Practice Address - Country:US
Practice Address - Phone:206-302-2200
Practice Address - Fax:206-302-2210
Is Sole Proprietor?:No
Enumeration Date:2012-09-10
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60320642101YM0800X, 101Y00000X
WAMC60332588101YM0800X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor