MEDICARE: JESSICA PIERRE-LOUIS 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
1	101YP2500X	Professional Counselor	PC013669	PA

General Provider Information

NPI Number	:	1780355115
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA PIERRE-LOUIS LPC

Provider Business Mailing Address
First Line	:	7115 DUNGAN RD
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19111-4119
Country	:	US
Telephone Number	:	267-242-6520
Fax Number	:

Provider Business Practice Location Address
First Line	:	7115 DUNGAN RD
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19111-4119
Country	:	US
Telephone Number	:	267-242-6520
Fax Number	:

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

Provider Enumeration Date	:	09/24/2021
Last Update Date	:	09/24/2021

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Directions to “ JESSICA PIERRE-LOUIS LPC” Practice Location

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