Provider Demographics
NPI:1073801684
Name:LANCE, JESSICA L (LPCC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:L
Last Name:LANCE
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:OH
Mailing Address - Zip Code:44622-2934
Mailing Address - Country:US
Mailing Address - Phone:330-343-6600
Mailing Address - Fax:330-343-6405
Practice Address - Street 1:130 W 3RD ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:OH
Practice Address - Zip Code:44622-2934
Practice Address - Country:US
Practice Address - Phone:330-343-6600
Practice Address - Fax:330-343-6405
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-17
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor