Healthcare Provider Details

I. General information

NPI: 1306775929
Provider Name (Legal Business Name): JENNIFER HENDRICKS LMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 FRANKLYN ST 102
NANAIMO BC
V9T0A2
CA

IV. Provider business mailing address

301 FRANKLYN ST 102
NANAIMO BC
V9T0A2
CA

V. Phone/Fax

Practice location:
  • Phone:
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHCA.MC.61523433
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: