Provider Demographics
NPI:1689027963
Name:BEAUVAIS, JENNIFER (LMHC, BP, MA,)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:BEAUVAIS
Suffix:
Gender:F
Credentials:LMHC, BP, MA,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2913
Mailing Address - Street 2:
Mailing Address - City:LEAVENWORTH
Mailing Address - State:WA
Mailing Address - Zip Code:98826-2150
Mailing Address - Country:US
Mailing Address - Phone:509-433-7079
Mailing Address - Fax:
Practice Address - Street 1:203 MISSION AVE STE 118
Practice Address - Street 2:
Practice Address - City:CASHMERE
Practice Address - State:WA
Practice Address - Zip Code:98815-1619
Practice Address - Country:US
Practice Address - Phone:509-334-7079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-21
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60782792101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health