MEDICARE: JESSICA MARIE WATT DOUGHERTY LPC, ALPS, NCC

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	101YP2500X	Professional Counselor	1892	WV

General Provider Information

NPI Number	:	1528914553
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA MARIE WATT DOUGHERTY LPC, ALPS, NCC

Provider Business Mailing Address
First Line	:	100 1/2 14TH ST
Second Line	:
City	:	WHEELING
State	:	WV
Zip	:	26003-3407
Country	:	US
Telephone Number	:	304-830-7546
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 1/2 14TH ST
Second Line	:
City	:	WHEELING
State	:	WV
Zip	:	26003-3407
Country	:	US
Telephone Number	:	304-830-7546
Fax Number	:

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

Provider Enumeration Date	:	03/10/2026
Last Update Date	:	03/10/2026

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