Individual provider · Type 1 NPI

Jennie Lane L. Bicknell, RADT

Addiction (Substance Use Disorder) Counselor · San Rafael, CA

NPI number 1396579611 Active

Practice location

603 D St
San Rafael, CA 94901-3719

Call (415) 454-9444 Map

Mailing address

1208 Sir Francis Drake Blvd Apt 4
San Anselmo, CA 94960-1745

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XR1518840823 (CA)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1396579611

Jennie Lane L. Bicknell, RADT's National Provider Identifier is 1396579611, issued on Aug 28, 2024. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in San Rafael, CA. The record was last updated on Sep 29, 2026.