Lakeshore Mind and Family
NPI #1003791971 in Longview, Washington
Provider Information
- NPI Number
- 1003791971
- Entity Type
- Organization
- Organization Name
- Lakeshore Mind and Family
- Primary Specialty
- Clinic/Center - Adult Mental Health
- Enumeration Date
- Aug 8, 2025
- Last Updated
- Aug 8, 2025
Practice Location
- Address
- 1329 BROADWAY ST STE 204
- City
- Longview
- State
- Washington
- ZIP Code
- 98632-3731
- Phone
- (360) 984-9018
Authorized Official
- Name
- ANIEZKA JENISSEN
- Title
- OWNER
- Phone
- (360) 984-9018
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Mental Health — Mental Health |
| Clinic/Center - Adult Mental Health — Adult Mental Health |
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