Provider Demographics
NPI:1740412014
Name:PARISEAU, JENNIFER ANNE (MS, LMHC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANNE
Last Name:PARISEAU
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:
Other - Last Name:PARISEAU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, LMHC
Mailing Address - Street 1:8329 NE 148TH PL
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:WA
Mailing Address - Zip Code:98028-4723
Mailing Address - Country:US
Mailing Address - Phone:425-354-7823
Mailing Address - Fax:
Practice Address - Street 1:300 N PEARL ST STE 201
Practice Address - Street 2:
Practice Address - City:ELLENSBURG
Practice Address - State:WA
Practice Address - Zip Code:98926-4003
Practice Address - Country:US
Practice Address - Phone:509-306-1118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-19
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00011138101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health