Provider Demographics
NPI:1508226127
Name:CARMICHAEL, JENNIFER (CADC II)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:CARMICHAEL
Suffix:
Gender:F
Credentials:CADC II
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:CHRISTINE
Other - Last Name:CULP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CADC II
Mailing Address - Street 1:17 SW FRAZER AVE STE 282
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:OR
Mailing Address - Zip Code:97801-0048
Mailing Address - Country:US
Mailing Address - Phone:541-278-6330
Mailing Address - Fax:541-567-2856
Practice Address - Street 1:17 SW FRAZER AVE STE 282
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-0048
Practice Address - Country:US
Practice Address - Phone:541-278-6330
Practice Address - Fax:541-567-2856
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-24
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)