Provider Demographics
NPI:1659691038
Name:JEANNETTE ROWELL
Entity Type:Organization
Organization Name:JEANNETTE ROWELL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEANNETTE
Authorized Official - Middle Name:R
Authorized Official - Last Name:ROWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:503-365-8111
Mailing Address - Street 1:495 STATE ST
Mailing Address - Street 2:#340
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-4384
Mailing Address - Country:US
Mailing Address - Phone:503-365-8111
Mailing Address - Fax:
Practice Address - Street 1:495 STATE ST
Practice Address - Street 2:#340
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-4384
Practice Address - Country:US
Practice Address - Phone:503-365-8111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-08
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC2357101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty