Provider Demographics
NPI:1386122547
Name:THERAPY BY JENNY, LLC
Entity type:Organization
Organization Name:THERAPY BY JENNY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:206-377-9082
Mailing Address - Street 1:10441 LEEWAY AVE NW
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-8805
Mailing Address - Country:US
Mailing Address - Phone:206-377-9082
Mailing Address - Fax:
Practice Address - Street 1:7500 OLD MILITARY RD NE
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98311-3241
Practice Address - Country:US
Practice Address - Phone:360-698-9258
Practice Address - Fax:360-698-9296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-31
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty