MS. JENNIFER LYNN CANAAN CDP - NPI 1174095392

Q: What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101YA0400X and a focus in Addiction (Substance Use Disorder).

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About Ms. Jennifer Lynn Canaan Cdp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. JENNIFER LYNN CANAAN CDP (NPI 1174095392) is an individual addiction (substance use disorder) provider in Chehalis, Washington, licensed in Washington (CP60411031) and active in the NPI registry since December 2018.

NPPES Registry Identity

NPI1174095392

Entity TypeIndividualFemale

Primary Taxonomy101YA0400X

Provider Legal NameMS. JENNIFER LYNN CANAANCredential: CDP

Location Address505 SE ADAMS AVEChehalis, WA 98532-3031

Mailing Address4317 Ne 66th Ave Apt N141Vancouver, WA 98661-3291 · (360) 521-2566

Phone(360) 266-5029

Fax(360) 740-2551

Sole ProprietorNo

Enumeration DateDecember 28, 2018

✔ NPI 1174095392 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers

Taxonomy Code101YA0400X

License✔ Licensed in WA · CP60411031

505 SE ADAMS AVE, Chehalis, WA 98532

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Other Identifiers 2

MedicaidCP60411031WA

OtherCP60411031WA · Department Of Health

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. NATALIE LEE OLSON CDPT

Counselor (Addiction (Substance Use Disorder))