Provider Demographics
NPI:1245491836
Name:PARSONS, JEANETTE EMILY (LPC)
Entity type:Individual
Prefix:MRS
First Name:JEANETTE
Middle Name:EMILY
Last Name:PARSONS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12015 SW FAIRCREST ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-4617
Mailing Address - Country:US
Mailing Address - Phone:503-840-0065
Mailing Address - Fax:
Practice Address - Street 1:852 SW 21ST AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-1604
Practice Address - Country:US
Practice Address - Phone:503-840-0065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC0018101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORC0018OtherLICENSED PROFESSIONAL COUNSELOR