Healthcare Provider Details

I. General information

NPI: 1548184757
Provider Name (Legal Business Name): JESSICA BELL TACKETT MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 1/2 MAIN ST STE F
POINT PLEASANT WV
25550-1121
US

IV. Provider business mailing address

486 GLENWOOD RD
MILTON WV
25541-6841
US

V. Phone/Fax

Practice location:
  • Phone: 304-812-5426
  • Fax:
Mailing address:
  • Phone: 304-633-7088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: