Provider Demographics
NPI:1700658911
Name:RANALLI, JENNIFER (LLPC)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:RANALLI
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6225 COPELAND AVE APT A
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49048-6025
Mailing Address - Country:US
Mailing Address - Phone:269-251-4266
Mailing Address - Fax:
Practice Address - Street 1:471 W SOUTH ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-4678
Practice Address - Country:US
Practice Address - Phone:269-350-4143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451019487101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional