Provider Demographics
NPI:1619588878
Name:KINNEY, JAREB LEE (LPCC)
Entity type:Individual
Prefix:MR
First Name:JAREB
Middle Name:LEE
Last Name:KINNEY
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:504 E CENTRAL AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58701-4000
Mailing Address - Country:US
Mailing Address - Phone:701-390-1501
Mailing Address - Fax:701-890-1510
Practice Address - Street 1:504 E CENTRAL AVE STE 301
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-4000
Practice Address - Country:US
Practice Address - Phone:701-390-1501
Practice Address - Fax:701-890-1510
Is Sole Proprietor?:No
Enumeration Date:2020-08-12
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1055-3-1-20-465101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional