Provider Demographics
NPI:1336955442
Name:STEINMANN, JACLYN IVY (LPCA)
Entity type:Individual
Prefix:
First Name:JACLYN
Middle Name:IVY
Last Name:STEINMANN
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:MISS
Other - First Name:JACLYN
Other - Middle Name:
Other - Last Name:STEINMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:JACLYN COSSART
Mailing Address - Street 1:180 LITHIA WAY
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-1891
Mailing Address - Country:US
Mailing Address - Phone:541-843-4848
Mailing Address - Fax:
Practice Address - Street 1:180 LITHIA WAY STE 204
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-1891
Practice Address - Country:US
Practice Address - Phone:541-843-4848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-04
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR10477101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health