Individual
MISS JENNA MICHELE KIMMINAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
6910 N MAIN ST UNIT 52, GRANGER, IN 46530-8412
(574) 231-6766
(833) 249-2411
Mailing address
6910 N MAIN ST UNIT 52, GRANGER, IN 46530-8412
(574) 231-6766
(833) 249-2411
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
IN
1041C0700X
Clinical Social Worker
Primary
34012832A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34012832A
LCSW
IN
01
—
99014465A
INDIANA PROFESSIONAL LICENSING AGENCY
IN
Enumeration date
05/24/2021
Last updated
04/28/2026
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