Healthcare Provider Details

I. General information

NPI: 1497527998
Provider Name (Legal Business Name): JESSICA LYNN GUMIENNY LPCMH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2023
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 NAAMANS RD STE 110
CLAYMONT DE
19703-2301
US

IV. Provider business mailing address

650 NAAMANS RD STE 110
CLAYMONT DE
19703-2301
US

V. Phone/Fax

Practice location:
  • Phone: 302-224-1400
  • Fax: 302-224-1402
Mailing address:
  • Phone: 302-224-1400
  • Fax: 302-224-1402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC-0011505
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: