Provider Demographics
NPI:1558805101
Name:MCBRIDE MCNAMARA, JENNIFER (MA, LAMFT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:MCBRIDE MCNAMARA
Suffix:
Gender:F
Credentials:MA, LAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 MINNESOTA ST
Mailing Address - Street 2:SUITE 1500
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55101-2190
Mailing Address - Country:US
Mailing Address - Phone:612-888-2522
Mailing Address - Fax:
Practice Address - Street 1:445 MINNESOTA ST
Practice Address - Street 2:SUITE 1500
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-2190
Practice Address - Country:US
Practice Address - Phone:612-888-2522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-15
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MN3388106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health