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General NPI Number Information
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NPI Number | 1881962850
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Entity Type | Individual
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Provider Name | JENNIFER L FADDEN MA, LMFT
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Gender | Female
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Dates
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Enumeration Date | 12/06/2011
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 307 S 12TH AVE STE 4B
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City | YAKIMA
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State | WA
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Zip | 98902-3137
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Country | US
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Telephone | 509-575-8457
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 190
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City | TOPPENISH
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State | WA
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Zip | 98948-0190
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Country | US
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Telephone | 509-865-2395
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LF60529993
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LF60529993
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License Number State | WA
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