Healthcare Provider Details

I. General information

NPI: 1235098534
Provider Name (Legal Business Name): JESSICA LOTT THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2026
Last Update Date: 01/21/2026
Certification Date: 01/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 LELIA DR
JACKSON MS
39216-4816
US

IV. Provider business mailing address

2045 SOUTHWOOD RD
JACKSON MS
39211-6032
US

V. Phone/Fax

Practice location:
  • Phone: 601-717-0487
  • Fax:
Mailing address:
  • Phone: 601-717-0487
  • 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: JESSICA CHAPMAN LOTT
Title or Position: OWNER
Credential: LCSW
Phone: 601-717-0487