Provider Demographics
NPI:1093187411
Name:STEVENSON, JESSICA ANN (LMHC, LCMHC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:ANN
Last Name:STEVENSON
Suffix:
Gender:F
Credentials:LMHC, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 RICHARDSON RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01863-1915
Mailing Address - Country:US
Mailing Address - Phone:603-421-7123
Mailing Address - Fax:
Practice Address - Street 1:500 N COMMERCIAL ST STE 500
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-1151
Practice Address - Country:US
Practice Address - Phone:603-421-7123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-25
Last Update Date:2022-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2050101YP2500X, 101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)