Provider Demographics
NPI:1538518790
Name:REDER, JENESSA (MA, LPC)
Entity Type:Individual
Prefix:
First Name:JENESSA
Middle Name:
Last Name:REDER
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:JENESSA
Other - Middle Name:
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:MPA GROUP NFP, LTD.
Mailing Address - Street 2:1217 SOUTH EUCLID AVE
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706
Mailing Address - Country:US
Mailing Address - Phone:989-891-6314
Mailing Address - Fax:
Practice Address - Street 1:1217 SOUTH EUCLID AVE
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-3311
Practice Address - Country:US
Practice Address - Phone:989-667-9661
Practice Address - Fax:989-667-9680
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-08
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401013009101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional