MEDICARE: JENNIFER FLORENCE LYDIA HEARIDGE MA LMHC

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
1	101YM0800X	Mental Health Counselor	LH60159915	WA

General Provider Information

NPI Number	:	1669589461
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER FLORENCE LYDIA HEARIDGE MA LMHC

Provider Business Mailing Address
First Line	:	PO BOX 30706
Second Line	:
City	:	BELLINGHAM
State	:	WA
Zip	:	98228-2706
Country	:	US
Telephone Number	:	360-305-3660
Fax Number	:	360-320-8540

Provider Business Practice Location Address
First Line	:	3150 ORLEANS ST BLDG B
Second Line	:
City	:	BELLINGHAM
State	:	WA
Zip	:	98226-9997
Country	:	US
Telephone Number	:	360-305-3660
Fax Number	:	360-320-8540

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	01/21/2026

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