Provider Demographics
NPI:1710595301
Name:ABRAMS, JENNA ALEXA (LCSW, LICSW)
Entity Type:Individual
Prefix:MRS
First Name:JENNA
Middle Name:ALEXA
Last Name:ABRAMS
Suffix:
Gender:F
Credentials:LCSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1485 BOBS HOLLOW LN
Mailing Address - Street 2:
Mailing Address - City:DUPONT
Mailing Address - State:WA
Mailing Address - Zip Code:98327-9744
Mailing Address - Country:US
Mailing Address - Phone:203-253-3204
Mailing Address - Fax:
Practice Address - Street 1:1485 BOBS HOLLOW LN
Practice Address - Street 2:
Practice Address - City:DUPONT
Practice Address - State:WA
Practice Address - Zip Code:98327-9744
Practice Address - Country:US
Practice Address - Phone:253-234-4648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW614826521041C0700X
NCC0153781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical