Provider Demographics
NPI:1104164227
Name:REISINGER, JENNIFER (MA, LMHC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:REISINGER
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5800 SOUNDVIEW DR BLDG B
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-2000
Mailing Address - Country:US
Mailing Address - Phone:425-501-9685
Mailing Address - Fax:
Practice Address - Street 1:5800 SOUNDVIEW DR BLDG B
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-2000
Practice Address - Country:US
Practice Address - Phone:425-501-9685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-24
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
WALH60468964101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health