Provider Demographics
NPI:1811355522
Name:REINA, JEANNE (LMHCA)
Entity type:Individual
Prefix:
First Name:JEANNE
Middle Name:
Last Name:REINA
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 1:9320 LIMA TER S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-6016
Mailing Address - Country:US
Mailing Address - Phone:425-770-6439
Mailing Address - Fax:
Practice Address - Street 1:10512 NE 68TH ST
Practice Address - Street 2:BLDG. C, SUITE 202
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-7002
Practice Address - Country:US
Practice Address - Phone:425-770-6439
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-09
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60196623101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health