Individual provider · Type 1 NPI

Jessica L. Minckley, LMHC, ATR-BC

Mental Health Counselor · Los Angeles, CA

NPI number 1790401339 Active

Practice location

3370 Glendale Blvd # 733
Los Angeles, CA 90039-4836

Call (323) 612-0571 Map

Fax (206) 703-3372

Mailing address

3512 La Clede Ave Apt 102
Los Angeles, CA 90039-1950

Specialties and licenses

TaxonomyCodeLicense
Art Therapist 221700000X22455
Mental Health Counselor 101YM0800X6161075 (ID)
Mental Health Counselor Primary 101YM0800XLH61457229 (WA)

Mental Health Counselor: Definition to come...

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About NPI 1790401339

Jessica L. Minckley, LMHC, ATR-BC's National Provider Identifier is 1790401339, issued on Oct 14, 2022. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Los Angeles, CA. The record was last updated on Jul 13, 2026.