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NPI Code Detail

MEDICARE: JESSICA LAELAH MESSMAN LPC-A

MEDICARE: JESSICA LAELAH MESSMAN LPC-A
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
1101YM0800XMental Health Counselor94033TX

General Provider Information

NPI Number : 1114760139
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA LAELAH MESSMAN LPC-A
Provider Business Mailing Address
First Line : 3509 HULEN ST STE 107
Second Line :
City : FORT WORTH
State : TX
Zip : 76107-6834
Country : US
Telephone Number : 972-652-0677
Fax Number :
Provider Business Practice Location Address
First Line : 3509 HULEN ST STE 107
Second Line :
City : FORT WORTH
State : TX
Zip : 76107-6834
Country : US
Telephone Number : 972-652-0677
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2024
Last Update Date : 06/17/2024

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