Provider Demographics
NPI:1356731798
Name:VANALSTINE, JENNAH (MA, LPCC)
Entity type:Individual
Prefix:
First Name:JENNAH
Middle Name:
Last Name:VANALSTINE
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4149 N HOLLAND SYLVANIA RD STE 8
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-2590
Mailing Address - Country:US
Mailing Address - Phone:419-509-9529
Mailing Address - Fax:
Practice Address - Street 1:4149 N HOLLAND SYLVANIA RD STE 8
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-2590
Practice Address - Country:US
Practice Address - Phone:419-509-9529
Practice Address - Fax:567-316-6433
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-23
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1300065101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health