Provider Demographics
NPI:1326397043
Name:THURSTON, JENNIFER LYNETTE (LMHC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNETTE
Last Name:THURSTON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LYNETTE
Other - Last Name:CONNORS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18914 ANGELINE AVE NE
Mailing Address - Street 2:
Mailing Address - City:SUQUAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98392-9779
Mailing Address - Country:US
Mailing Address - Phone:360-994-0348
Mailing Address - Fax:
Practice Address - Street 1:18914 ANGELINE AVE NE
Practice Address - Street 2:
Practice Address - City:SUQUAMISH
Practice Address - State:WA
Practice Address - Zip Code:98392-9779
Practice Address - Country:US
Practice Address - Phone:360-994-0348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-10
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60320642101Y00000X, 101YM0800X
WAMC60332588101Y00000X, 101YM0800X
WALH60538673101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor