Provider Demographics
NPI:1770879777
Name:MARKIEWICZ, JENNINE MARIE (LMFT)
Entity type:Individual
Prefix:
First Name:JENNINE
Middle Name:MARIE
Last Name:MARKIEWICZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:JENNINE
Other - Middle Name:MARIE
Other - Last Name:STUERTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:PO BOX 530077
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30353-0077
Mailing Address - Country:US
Mailing Address - Phone:888-588-8995
Mailing Address - Fax:510-756-0812
Practice Address - Street 1:2105 MARTIN LUTHER KING JR WAY FL 1
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94704-1108
Practice Address - Country:US
Practice Address - Phone:888-588-8995
Practice Address - Fax:510-756-0812
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT87586106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty