MEDICARE: JESSICA FAY WOOSLEY MFT-A

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1912866708
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA FAY WOOSLEY MFT-A

Provider Business Mailing Address
First Line	:	8802 NOTTINGHAM PKWY
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40222-5272
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1031 VERNA LN
Second Line	:
City	:	BEREA
State	:	KY
Zip	:	40403-8731
Country	:	US
Telephone Number	:	502-389-7592
Fax Number	:

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

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/19/2026

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