Provider Demographics
NPI:1821864935
Name:JASINSKI, JOANNE M (MA, LPC)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:M
Last Name:JASINSKI
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 LIVINGSTON BLVD FL 2
Mailing Address - Street 2:
Mailing Address - City:GAYLORD
Mailing Address - State:MI
Mailing Address - Zip Code:49735-8351
Mailing Address - Country:US
Mailing Address - Phone:989-732-6292
Mailing Address - Fax:
Practice Address - Street 1:800 LIVINGSTON BLVD FL 2
Practice Address - Street 2:
Practice Address - City:GAYLORD
Practice Address - State:MI
Practice Address - Zip Code:49735-8351
Practice Address - Country:US
Practice Address - Phone:989-732-6292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-29
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401222781101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional