MEDICARE: JESSICA HORNING LPC PLLC

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
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1235835125
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JESSICA HORNING LPC PLLC

Provider Business Mailing Address
First Line	:	1519 HURON AVE
Second Line	:
City	:	ROYAL OAK
State	:	MI
Zip	:	48073-4714
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1519 HURON AVE
Second Line	:
City	:	ROYAL OAK
State	:	MI
Zip	:	48073-4714
Country	:	US
Telephone Number	:	248-722-1811
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST
Name	:	JESSICA R HORNING
Credential	:	LPC
Telephone Number	:	248-722-1811

Provider Enumeration Date	:	02/02/2023
Last Update Date	:	02/02/2023

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