Provider Demographics
NPI:1801027941
Name:BARAJAS, JENNIFER A (MS, LPC)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:A
Last Name:BARAJAS
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:A
Other - Last Name:BENKERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LLPC
Mailing Address - Street 1:1939 S DIVISION AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49507
Mailing Address - Country:US
Mailing Address - Phone:616-247-3815
Mailing Address - Fax:
Practice Address - Street 1:1031 COURTNEY ST NW
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49504-3052
Practice Address - Country:US
Practice Address - Phone:616-209-8343
Practice Address - Fax:616-732-6391
Is Sole Proprietor?:No
Enumeration Date:2009-08-06
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 101YM0800X, 101YP2500X
MI6401011710101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health