Healthcare Provider Details

I. General information

NPI: 1326397043
Provider Name (Legal Business Name): JENNIFER LYNETTE THURSTON LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER LYNETTE CONNORS

II. Dates (important events)

Enumeration Date: 09/10/2012
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9723 COPPERTOP LOOP NE STE 204
BAINBRIDGE ISLAND WA
98110-3699
US

IV. Provider business mailing address

9723 COPPERTOP LOOP NE STE 204
BAINBRIDGE ISLAND WA
98110-3699
US

V. Phone/Fax

Practice location:
  • Phone: 206-588-5380
  • Fax:
Mailing address:
  • Phone: 206-588-5380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberMC60332588
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberCG60320642
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMC60332588
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCG60320642
License Number StateWA
# 5
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH60538673
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: