Provider Demographics
NPI:1548839392
Name:JAEGER, JENNIFER (MA, MHP, CMHS, LMHC)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:JAEGER
Suffix:
Gender:F
Credentials:MA, MHP, CMHS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3034 APPLEHILL CT NE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-6700
Mailing Address - Country:US
Mailing Address - Phone:360-259-2964
Mailing Address - Fax:
Practice Address - Street 1:4405 7TH AVE SE STE 200
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-1055
Practice Address - Country:US
Practice Address - Phone:360-207-0248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-24
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00011311101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health