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NPI Code Detail

MEDICARE: MRS. JESSICA STAGG MEYERS LPC

MEDICARE: MRS. JESSICA STAGG MEYERS 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 Counselor37PC00495700NJ

General Provider Information

NPI Number : 1710377460
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JESSICA STAGG MEYERS LPC
Provider Business Mailing Address
First Line : 225 N MICHIGAN AVE STE 1430
Second Line :
City : CHICAGO
State : IL
Zip : 60601-7653
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 225 N MICHIGAN AVE STE 1430
Second Line :
City : CHICAGO
State : IL
Zip : 60601-7653
Country : US
Telephone Number : 201-417-3464
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2015
Last Update Date : 12/16/2022

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