Provider Demographics
NPI:1790822658
Name:THOMPSON-JENSSEN, RAYNA J (LPCC-S)
Entity Type:Individual
Prefix:
First Name:RAYNA
Middle Name:J
Last Name:THOMPSON-JENSSEN
Suffix:
Gender:F
Credentials:LPCC-S
Other - Prefix:
Other - First Name:RAYNA
Other - Middle Name:J
Other - Last Name:JENSSEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:150 N LIMESTONE ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45501-5001
Mailing Address - Country:US
Mailing Address - Phone:937-390-2121
Mailing Address - Fax:
Practice Address - Street 1:150 N LIMESTONE ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45501-5001
Practice Address - Country:US
Practice Address - Phone:937-390-2121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0002160-SUPV101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional