Provider Demographics
NPI:1124230149
Name:COSBY, JESSICA LEA (MA LPC RPT-S)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:LEA
Last Name:COSBY
Suffix:
Gender:F
Credentials:MA LPC RPT-S
Other - Prefix:MS
Other - First Name:JESSICA
Other - Middle Name:LEA
Other - Last Name:KROPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA LPC
Mailing Address - Street 1:315 LIBERTY STREET
Mailing Address - Street 2:
Mailing Address - City:CLARION
Mailing Address - State:PA
Mailing Address - Zip Code:16214-1829
Mailing Address - Country:US
Mailing Address - Phone:814-316-5491
Mailing Address - Fax:
Practice Address - Street 1:240 LIBERTY ST
Practice Address - Street 2:LIBERTY STREET COUNSELING CENTER
Practice Address - City:CLARION
Practice Address - State:PA
Practice Address - Zip Code:16214-1829
Practice Address - Country:US
Practice Address - Phone:814-316-5491
Practice Address - Fax:814-226-5329
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003523101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional