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General NPI Number Information
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NPI Number | 1932553518
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Entity Type | Individual
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Provider Name | JESSICA BYERS LPC
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Gender | Female
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Dates
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Enumeration Date | 04/20/2016
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Last Update Date | 11/11/2020
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Provider Practice Location Address
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Address Line | 77 ORANGE RD APT 18
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City | MONTCLAIR
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State | NJ
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Zip | 07042-2153
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Country | US
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Telephone | 859-393-1118
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Fax |
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Provider Business Mailing Address
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Address Line | 77 ORANGE RD APT 18
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City | MONTCLAIR
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State | NJ
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Zip | 07042-2153
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Country | US
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Telephone | 859-393-1118
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 37PC00676000
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License Number State | NJ
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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 | 175280
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License Number State | KY
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