Provider Demographics
NPI:1467570283
Name:STORBECK, JENNA ALISHA (MA, LPCC)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:ALISHA
Last Name:STORBECK
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:HENNEPIN COUNTY EMH CRISIS SERVICES
Mailing Address - Street 2:525 PORTLAND AVENUE MC 963
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55415-1533
Mailing Address - Country:US
Mailing Address - Phone:612-596-1223
Mailing Address - Fax:612-677-6248
Practice Address - Street 1:HENNEPIN COUNTY EMH CRISIS SERVICES
Practice Address - Street 2:525 PORTLAND AVENUE MC 963
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55415-1533
Practice Address - Country:US
Practice Address - Phone:612-596-1223
Practice Address - Fax:612-677-6248
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC02077101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional