Healthcare Provider Details

I. General information

NPI: 1730976838
Provider Name (Legal Business Name): JESSICA CARRATELLI LMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSIE JOHNSON

II. Dates (important events)

Enumeration Date: 04/22/2025
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2209 E 32ND ST
TACOMA WA
98404-4922
US

IV. Provider business mailing address

5020 MAIN ST APT 322
TACOMA WA
98407-3227
US

V. Phone/Fax

Practice location:
  • Phone: 253-593-0232
  • Fax:
Mailing address:
  • Phone: 253-303-1057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: