Provider Demographics
NPI:1093378424
Name:CROSS, JAMIE (MS, LPC)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:CROSS
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:
Other - Last Name:RIPPERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:523 PLYMOUTH RD STE 215
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-1667
Mailing Address - Country:US
Mailing Address - Phone:610-825-9400
Mailing Address - Fax:
Practice Address - Street 1:523 PLYMOUTH RD STE 215
Practice Address - Street 2:
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-1667
Practice Address - Country:US
Practice Address - Phone:610-825-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-22
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004012101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional