Provider Demographics
NPI:1770895286
Name:JURGENSEN, THERESA RENEE (MSW)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:RENEE
Last Name:JURGENSEN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 ROSSCRAGGON RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-1163
Mailing Address - Country:US
Mailing Address - Phone:828-654-7700
Mailing Address - Fax:828-704-0288
Practice Address - Street 1:38 ROSSCRAGGON RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-1163
Practice Address - Country:US
Practice Address - Phone:828-654-7700
Practice Address - Fax:828-704-0288
Is Sole Proprietor?:No
Enumeration Date:2010-07-13
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health