Provider Demographics
NPI:1164788220
Name:CARRION, JESSICA (LPC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:CARRION
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 1:5400 CHAMBERS HILL RD
Mailing Address - Street 2:TEAMCARE BEHAVIORAL HEALTH
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111
Mailing Address - Country:US
Mailing Address - Phone:717-525-9804
Mailing Address - Fax:717-525-9862
Practice Address - Street 1:5400 CHAMBERS HILL RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17111-2545
Practice Address - Country:US
Practice Address - Phone:717-525-9804
Practice Address - Fax:717-525-9862
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-03
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005467101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional