MEDICARE: JESSICA RENEE CARLINGTON LPCA

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	101Y00000X	Counselor	246278	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447844527
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA RENEE CARLINGTON LPCA

Provider Business Mailing Address
First Line	:	1589 HIGHWAY 15 S STE 270
Second Line	:
City	:	JACKSON
State	:	KY
Zip	:	41339-9634
Country	:	US
Telephone Number	:	606-666-4668
Fax Number	:	606-666-4670

Provider Business Practice Location Address
First Line	:	1589 HIGHWAY 15 S STE 270
Second Line	:
City	:	JACKSON
State	:	KY
Zip	:	41339-9634
Country	:	US
Telephone Number	:	606-666-4668
Fax Number	:	606-666-4670

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2021
Last Update Date	:	03/01/2021

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Directions to “ JESSICA RENEE CARLINGTON LPCA” Practice Location

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