Provider Demographics
NPI:1760878805
Name:CHRISTOPHEL LICHTI, JENNIFER L (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:CHRISTOPHEL LICHTI
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:6626 E 75TH STREET
Mailing Address - Street 2:SUITE 500
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2890
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:825 EASTLAKE AVENUE E.
Practice Address - Street 2:MAIL STOP K2-231
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-1023
Practice Address - Country:US
Practice Address - Phone:206-606-5691
Practice Address - Fax:206-606-1074
Is Sole Proprietor?:No
Enumeration Date:2015-04-15
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN34005191A1041C0700X
WALW610441351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical