Provider Demographics
NPI:1184088387
Name:TRIPODI-MCILWEE, JENNA MARIE (LCMFT)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:MARIE
Last Name:TRIPODI-MCILWEE
Suffix:
Gender:F
Credentials:LCMFT
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:MARIE
Other - Last Name:TRIPODI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCMFT
Mailing Address - Street 1:322 HOUSTON ST STE 107
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-6497
Mailing Address - Country:US
Mailing Address - Phone:785-491-7871
Mailing Address - Fax:517-258-2951
Practice Address - Street 1:330 POYNTZ AVE STE 270
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-6332
Practice Address - Country:US
Practice Address - Phone:785-491-7871
Practice Address - Fax:517-258-2951
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-13
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2860106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist