Provider Demographics
NPI:1598379877
Name:BAAS, JENNIFER (LLPC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:BAAS
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3608 THORNAPPLE RIVER DR SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-9171
Mailing Address - Country:US
Mailing Address - Phone:616-323-4982
Mailing Address - Fax:
Practice Address - Street 1:648 MONROE AVE NW STE 100
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-6714
Practice Address - Country:US
Practice Address - Phone:616-916-3711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-03
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401009360101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional