Provider Demographics
NPI:1164199972
Name:JESSICA LEE MFT
Entity Type:Organization
Organization Name:JESSICA LEE MFT
Other - Org Name:JL HOPE COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:808-221-1549
Mailing Address - Street 1:98-211 PALI MOMI ST STE 635
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-4322
Mailing Address - Country:US
Mailing Address - Phone:808-518-1707
Mailing Address - Fax:
Practice Address - Street 1:98-211 PALI MOMI ST STE 635
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4322
Practice Address - Country:US
Practice Address - Phone:808-518-1707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-28
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty