Provider Demographics
NPI:1033729363
Name:GAZZOLA, JESSICA KATHRYN (LPC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:KATHRYN
Last Name:GAZZOLA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-2052
Mailing Address - Country:US
Mailing Address - Phone:412-452-7443
Mailing Address - Fax:
Practice Address - Street 1:1500 RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-2052
Practice Address - Country:US
Practice Address - Phone:412-452-7443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-02
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional