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General NPI Number Information
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NPI Number | 1508562513
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Entity Type | Individual
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Provider Name | JESSICA LYNNE UTLEY LPC, LCPC
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Gender | Female
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Dates
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Enumeration Date | 02/01/2023
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Last Update Date | 07/03/2025
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Provider Practice Location Address
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Address Line | 550 S WATTERS RD
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City | ALLEN
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State | TX
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Zip | 75013-5223
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Country | US
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Telephone | 469-457-4929
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Fax |
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Provider Business Mailing Address
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Address Line | 2931 RIDGE RD STE 101-1100
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City | ROCKWALL
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State | TX
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Zip | 75032-6670
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Country | US
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Telephone | 469-457-4929
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 7571962
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 86018
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License Number State | TX
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