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General NPI Number Information
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NPI Number | 1508577818
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Entity Type | Individual
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Provider Name | JESSICA MINER LPC
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Gender | Female
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Dates
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Enumeration Date | 12/07/2022
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 3012 BUSINESS PARK CIR STE 700
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City | GOODLETTSVILLE
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State | TN
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Zip | 37072-3191
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Country | US
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Telephone | 154-455-9906
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Fax |
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Provider Business Mailing Address
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Address Line | 1050 GLENBROOK WAY STE 480-208
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-1241
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Country | US
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Telephone | 615-445-5990
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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 | 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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