Provider Demographics
NPI:1114563525
Name:RICE, JAMIE TERESA (LPC)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:TERESA
Last Name:RICE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 100
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:WV
Mailing Address - Zip Code:26807-0100
Mailing Address - Country:US
Mailing Address - Phone:304-358-2355
Mailing Address - Fax:855-332-1388
Practice Address - Street 1:82 PINE STREET
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:WV
Practice Address - Zip Code:26807-0100
Practice Address - Country:US
Practice Address - Phone:304-358-2355
Practice Address - Fax:553-321-3888
Is Sole Proprietor?:No
Enumeration Date:2019-11-20
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2451101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional