Provider Demographics
NPI:1952867616
Name:PSENSKI, JESSICA (LMHCA)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:PSENSKI
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10517 NE 187TH ST
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-3067
Mailing Address - Country:US
Mailing Address - Phone:425-638-2127
Mailing Address - Fax:
Practice Address - Street 1:9757 NE JUANITA DR
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-4299
Practice Address - Country:US
Practice Address - Phone:425-638-2127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-18
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60891594101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA604-285-881OtherSECRETARY OF STATE