Jennie D Chrisenbery, MS

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

2204 Pacific Ave N
Long Beach, WA 98631-3300

Phone

(360) 642-3787

NPI assigned

Sep 5, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Jennie D Sedlacek Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Clatsop Behavioral Healthcare

  • Mental Illness Community Based Residential Treatment Facility
  • Warrenton, OR
  • NPI 1760833313
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1306195474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2204 PACIFIC AVE N",
            "city": "LONG BEACH",
            "state": "WA",
            "postal_code": "986313300",
            "telephone_number": "360-642-3787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 PACIFIC AVE N",
            "city": "LONG BEACH",
            "state": "WA",
            "postal_code": "986313300",
            "telephone_number": "360-642-3787"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "326 SE Marlin Ave",
            "address_purpose": "LOCATION",
            "city": "Warrenton",
            "state": "OR",
            "postal_code": "971469624",
            "country_code": "US",
            "telephone_number": "503-325-0241",
            "fax_number": "503-861-2043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHRISENBERY",
        "first_name": "JENNIE",
        "middle_name": "D",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-05",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIE",
            "last_name": "SEDLACEK",
            "middle_name": "D",
            "credential": "MS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michael Osvaldo Buelna
• Amber Bunker, RN, BSN
• Francisco J Caballero, CDPT
• Donald Paul Cantrell
• Krista Carver
• Nicolas Cibulka
• Dana Lynn Clark, SLPA
• Diana Rose Clarke
• Jody Cleveland, RN
• Coastal Health LLC

• Counselor in Long Beach, WA
• Providers in Long Beach, WA by specialty
• Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.