Individual provider · NPI-1

Jenna Abernathy, MA, LPC Intern, LMT

Counselor, Mental Health · Portland, OR

NPI number1407300205
StatusActive
Last updated in NPPESDec 4, 2019

Details

NPI
1407300205
Entity type
Individual (NPI-1)
Name
Jenna Abernathy
Credential
MA, LPC Intern, LMT
Sex
Female
Sole proprietor
Yes
Enumeration date
Aug 9, 2016
Last updated
Dec 4, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YM0800X Counselor, Mental Health–ORYes
225700000X Massage Therapist10987OR

Practice location

3537 N Williams Ave
Portland, OR 97227

Phone 503-309-8622

Mailing address

4545 Ne Mallory Ave
Portland, OR 97211-3330

Phone 503-309-8622

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