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General NPI Number Information
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NPI Number | 1306417191
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Entity Type | Individual
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Provider Name | MEREDITH ASHLEY JESSUP LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/02/2021
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Last Update Date | 10/05/2025
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Provider Practice Location Address
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Address Line | 101 S LOCUST ST STE 602
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City | DENTON
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State | TX
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Zip | 76201-6159
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Country | US
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Telephone | 972-348-0176
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Fax |
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Provider Business Mailing Address
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Address Line | 7462 WHITE OAK LN
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City | VERO BEACH
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State | FL
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Zip | 32966-2515
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Country | US
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Telephone | 269-689-2167
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 24950
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 63240
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License Number State | TX
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