Provider Demographics
NPI:1073749149
Name:HYLTON, JESSICA NICOLE (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:NICOLE
Last Name:HYLTON
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211A E WILSON ST
Mailing Address - Street 2:CAMPUS BOX 5013 WINGATE UNIVERSITY
Mailing Address - City:WINGATE
Mailing Address - State:NC
Mailing Address - Zip Code:28174-9664
Mailing Address - Country:US
Mailing Address - Phone:704-233-8246
Mailing Address - Fax:
Practice Address - Street 1:211A E WILSON ST
Practice Address - Street 2:CAMPUS BOX 5013 WINGATE UNIVERSITY
Practice Address - City:WINGATE
Practice Address - State:NC
Practice Address - Zip Code:28174-9664
Practice Address - Country:US
Practice Address - Phone:704-233-8246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-03
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6718101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor