Provider Demographics
NPI:1376896951
Name:WALTER, JINNEAN (MS, LPCC-S, NCC)
Entity Type:Individual
Prefix:
First Name:JINNEAN
Middle Name:
Last Name:WALTER
Suffix:
Gender:F
Credentials:MS, LPCC-S, NCC
Other - Prefix:
Other - First Name:JINNEAN
Other - Middle Name:
Other - Last Name:SILVERTHORNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LPCC-S, NCC
Mailing Address - Street 1:3095 KETTERING BLVD
Mailing Address - Street 2:
Mailing Address - City:MORAINE
Mailing Address - State:OH
Mailing Address - Zip Code:45439-1983
Mailing Address - Country:US
Mailing Address - Phone:937-293-8300
Mailing Address - Fax:
Practice Address - Street 1:3095 KETTERING BLVD
Practice Address - Street 2:
Practice Address - City:MORAINE
Practice Address - State:OH
Practice Address - Zip Code:45439-1983
Practice Address - Country:US
Practice Address - Phone:937-293-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-19
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0002925-SUPV101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional