=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164509527
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JESSICA LEE MCNABB LPC, LMFT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/01/2006
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1510 NAPOLEON ST
-----------------------------------------------------
City | MAMOU
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70554-2320
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 337-468-2333
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1686 HIGHWAY 1176
-----------------------------------------------------
City | BUNKIE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71322-7402
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 318-405-0020
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 3264
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 1059
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------