Healthcare Provider Details
I. General information
NPI: 1013985092
Provider Name (Legal Business Name): JESSICA M ESPADA LPC , NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 03/08/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
132 POPLAR GROVE CONNECTOR SUITE B
BOONE NC
28607-5915
US
IV. Provider business mailing address
132 POPLAR GROVE CONNECTOR SUITE B
BOONE NC
28607-5915
US
V. Phone/Fax
- Phone: 828-264-8759
- Fax: 828-262-5687
- Phone: 828-264-8759
- Fax: 828-262-5687
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | 87063 |
| License Number State | NC |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 4820 |
| License Number State | NC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: