Healthcare Provider Details

I. General information

NPI: 1295910693
Provider Name (Legal Business Name): JESSICA L WEBSTER MS, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2008
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

632 GERMANTOWN PIKE UNIT B
LAFAYETTE HILL PA
19444-1641
US

IV. Provider business mailing address

632 GERMANTOWN PIKE UNIT B
LAFAYETTE HILL PA
19444-1641
US

V. Phone/Fax

Practice location:
  • Phone: 267-973-7529
  • Fax:
Mailing address:
  • Phone: 267-973-7529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPC004174
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: