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NPI Code Detail

MEDICARE: JESSICA R DEMBY LPC

MEDICARE: JESSICA R DEMBY LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor75779TX
2101YM0800XMental Health Counselor75779TX

General Provider Information

NPI Number : 1093291718
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA R DEMBY LPC
Provider Business Mailing Address
First Line : 308 S FRIENDSWOOD DR STE 200
Second Line :
City : FRIENDSWOOD
State : TX
Zip : 77546-3989
Country : US
Telephone Number : 844-824-8775
Fax Number :
Provider Business Practice Location Address
First Line : 3355 W ALABAMA ST STE 195
Second Line :
City : HOUSTON
State : TX
Zip : 77098-1871
Country : US
Telephone Number : 844-824-8775
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2018
Last Update Date : 05/07/2024

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