Jeanne C Probasco, LCSW

Individual provider Active NPI Mental Health Counselor · Roseville, CA

NPI 1790096063 · NPPES record last updated Jul 1, 2010

Key facts

NPI
1790096063
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
26343 (CA)
Practice address
1660 E Roseville Pkwy
Roseville, CA 95661-3988
Phone
(916) 878-4027
NPI assigned
Jul 1, 2010
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
26343CAMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 26343 CA Yes

Addresses

Primary practice location

1660 E Roseville Pkwy
Roseville, CA 95661-3988

Mailing address

1660 E Roseville Pkwy
Roseville, CA 95661-3988
Phone (916) 878-4027

Other providers in Roseville, CA

All providers in Roseville, CA · Mental Health Counselor in California

Sources for this page

Verify at the official NPI Registry.