Provider Demographics
NPI:1366102162
Name:SPEKTOR, RED JENNIFER (MA, LMHCA)
Entity type:Individual
Prefix:MISS
First Name:RED
Middle Name:JENNIFER
Last Name:SPEKTOR
Suffix:
Gender:F
Credentials:MA, LMHCA
Other - Prefix:MISS
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:SPEKTOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, LMHCA
Mailing Address - Street 1:1203 JAMES ST APT 206
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2105
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:520 2ND AVE W APT 102
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98119-3977
Practice Address - Country:US
Practice Address - Phone:847-323-6463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-21
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61233506101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health