Provider Demographics
NPI:1740801042
Name:JASPERING, JENNICA CHRISTINE (LLMSW)
Entity Type:Individual
Prefix:
First Name:JENNICA
Middle Name:CHRISTINE
Last Name:JASPERING
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:JENNICA
Other - Middle Name:CHRISTINE
Other - Last Name:MILES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:497 WAUKONDA AVE
Mailing Address - Street 2:
Mailing Address - City:BENTON HARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:49022-3142
Mailing Address - Country:US
Mailing Address - Phone:269-926-1284
Mailing Address - Fax:269-926-1423
Practice Address - Street 1:497 WAUKONDA AVE
Practice Address - Street 2:
Practice Address - City:BENTON HARBOR
Practice Address - State:MI
Practice Address - Zip Code:49022-3142
Practice Address - Country:US
Practice Address - Phone:269-926-1284
Practice Address - Fax:269-926-1423
Is Sole Proprietor?:No
Enumeration Date:2020-04-28
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)