Provider Demographics
NPI:1144903691
Name:JESSICA CLAIRE COUNSELING
Entity type:Organization
Organization Name:JESSICA CLAIRE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INDEPENDENT CONTRACTOR COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:CLAIRE
Authorized Official - Last Name:CROSBY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:256-397-9342
Mailing Address - Street 1:25510 CAPSHAW RD
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35613-7341
Mailing Address - Country:US
Mailing Address - Phone:256-468-1170
Mailing Address - Fax:
Practice Address - Street 1:1101 MCMURTRIE DR NW STE A3
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35806-2470
Practice Address - Country:US
Practice Address - Phone:256-397-9342
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)