Provider Demographics
NPI:1821877895
Name:STRATTON, JENNIFER (MA LPCC MA LADC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:STRATTON
Suffix:
Gender:F
Credentials:MA LPCC MA LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1138 SPRUCE AVE
Mailing Address - Street 2:
Mailing Address - City:LUVERNE
Mailing Address - State:MN
Mailing Address - Zip Code:56156-4252
Mailing Address - Country:US
Mailing Address - Phone:507-920-0462
Mailing Address - Fax:
Practice Address - Street 1:1210 5TH AVE
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:MN
Practice Address - Zip Code:56187-2432
Practice Address - Country:US
Practice Address - Phone:507-376-4141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC04029101YM0800X
MN306717101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)