Healthcare Provider Details

I. General information

NPI: 1912866708
Provider Name (Legal Business Name): JESSICA FAY WOOSLEY MFT-A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2026
Last Update Date: 01/19/2026
Certification Date: 01/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1031 VERNA LN
BEREA KY
40403-8731
US

IV. Provider business mailing address

8802 NOTTINGHAM PKWY
LOUISVILLE KY
40222-5272
US

V. Phone/Fax

Practice location:
  • Phone: 502-389-7592
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: