Provider Demographics
NPI:1699786392
Name:ESSEX, JENNIFER MARY (LCSW, LMSW)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:MARY
Last Name:ESSEX
Suffix:
Gender:F
Credentials:LCSW, LMSW
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:MARY
Other - Last Name:JANKOWICZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW, LMSW
Mailing Address - Street 1:5823 LAKE HARBOR RD
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49441-6115
Mailing Address - Country:US
Mailing Address - Phone:231-799-2818
Mailing Address - Fax:
Practice Address - Street 1:433 SEMINOLE RD
Practice Address - Street 2:SUITE 110
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49444-3743
Practice Address - Country:US
Practice Address - Phone:231-739-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010848181041C0700X
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical