Provider Demographics
NPI:1679371991
Name:JENNIFER NEWBLOOM COUNSELING PLLC
Entity type:Organization
Organization Name:JENNIFER NEWBLOOM COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWBLOOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-249-7822
Mailing Address - Street 1:2627 W PLYMOUTH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98199-4124
Mailing Address - Country:US
Mailing Address - Phone:206-418-8205
Mailing Address - Fax:206-212-1878
Practice Address - Street 1:5608 17TH AVE NW # 916
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-5232
Practice Address - Country:US
Practice Address - Phone:206-249-7822
Practice Address - Fax:206-212-1878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health