Provider Demographics
NPI:1861770810
Name:DUGAN, JESSICA RUSH (MA, LPC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:RUSH
Last Name:DUGAN
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:RUSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6 JUNKIN PL
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24450-1822
Mailing Address - Country:US
Mailing Address - Phone:512-567-6358
Mailing Address - Fax:
Practice Address - Street 1:6 JUNKIN PL
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:VA
Practice Address - Zip Code:24450-1822
Practice Address - Country:US
Practice Address - Phone:512-567-6358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-25
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701010702101YP2500X
TX64553101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional