Provider Demographics
NPI:1912603499
Name:KAMINSKY, JESSICA CHRISTENSON (MA, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:CHRISTENSON
Last Name:KAMINSKY
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:671 TALCOTT AVE
Mailing Address - Street 2:
Mailing Address - City:LEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60439-2713
Mailing Address - Country:US
Mailing Address - Phone:630-408-8129
Mailing Address - Fax:
Practice Address - Street 1:1001 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-4928
Practice Address - Country:US
Practice Address - Phone:630-353-0697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.017378101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional