Provider Demographics
NPI:1528847845
Name:MCGINNESS, JENSEN RYAN (LPC)
Entity type:Individual
Prefix:
First Name:JENSEN
Middle Name:RYAN
Last Name:MCGINNESS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10464 W STATE HWY E
Mailing Address - Street 2:
Mailing Address - City:POTOSI
Mailing Address - State:MO
Mailing Address - Zip Code:63664-2034
Mailing Address - Country:US
Mailing Address - Phone:314-972-2938
Mailing Address - Fax:
Practice Address - Street 1:10464 W STATE HWY E
Practice Address - Street 2:
Practice Address - City:POTOSI
Practice Address - State:MO
Practice Address - Zip Code:63664-2034
Practice Address - Country:US
Practice Address - Phone:314-972-2934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022035111101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional