Healthcare Provider Details

I. General information

NPI: 1356424287
Provider Name (Legal Business Name): JESSICA L MEADE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1609 TREXLERTOWN RD
MACUNGIE PA
18062-9295
US

IV. Provider business mailing address

3351 SAW MILL DR
MACUNGIE PA
18062-9093
US

V. Phone/Fax

Practice location:
  • Phone: 484-206-7736
  • Fax:
Mailing address:
  • Phone: 215-720-6551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC018026
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: