Provider Demographics
NPI:1114649100
Name:BARRON, JESSICA SIMONE (LCDC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:SIMONE
Last Name:BARRON
Suffix:
Gender:F
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 MISSOURI ST APT 303
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77520-6653
Mailing Address - Country:US
Mailing Address - Phone:615-481-5568
Mailing Address - Fax:
Practice Address - Street 1:1200 MISSOURI ST APT 303
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77520-6653
Practice Address - Country:US
Practice Address - Phone:615-481-5568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-15
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)