Healthcare Provider Details

I. General information

NPI: 1922553064
Provider Name (Legal Business Name): JESSICA A OQUENDO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JESSICA MORRIS LPC

II. Dates (important events)

Enumeration Date: 08/18/2016
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1710 MACARTHUR RD STE 351
WHITEHALL PA
18052-5734
US

IV. Provider business mailing address

1710 MACARTHUR RD STE 351
WHITEHALL PA
18052-5734
US

V. Phone/Fax

Practice location:
  • Phone: 484-222-0541
  • Fax:
Mailing address:
  • Phone: 484-222-0541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC008642
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: