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NPI Code Detail

MEDICARE: MS. JENNIFER A BARAJAS MS, LPC

MEDICARE: MS. JENNIFER A BARAJAS MS, LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor
2101YM0800XMental Health Counselor
3101YP2500XProfessional Counselor6401011710MI
4101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1801027941
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JENNIFER A BARAJAS MS, LPC
Provider Business Mailing Address
First Line : 1939 S DIVISION AVE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49507
Country : US
Telephone Number : 616-247-3815
Fax Number :
Provider Business Practice Location Address
First Line : 1031 COURTNEY ST NW
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49504-3052
Country : US
Telephone Number : 616-209-8343
Fax Number : 616-732-6391
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2009
Last Update Date : 06/27/2023

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