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General NPI Number Information
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NPI Number | 1457059180
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Entity Type | Organization
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Legal Business Name | JESSICA JUERGENS MENTAL HEALTH COUNSELING LMHC PLLC
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Dates
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Enumeration Date | 02/22/2023
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Last Update Date | 02/22/2023
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Provider Practice Location Address
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Address Line | 307 WENDEL AVE
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City | TONAWANDA
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State | NY
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Zip | 14223-2558
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Country | US
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Telephone | 716-440-0704
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Fax |
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Provider Business Mailing Address
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Address Line | 307 WENDEL AVE
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City | TONAWANDA
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State | NY
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Zip | 14223-2558
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Country | US
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Telephone | 716-440-0704
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Fax |
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Authorized Official
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Title or Position | OWNER/MENTAL HEALTH COUNSELOR
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Name | JESSICA S JUERGENS
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Credential | LMHC
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Telephone | 716-440-0704
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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