Provider Demographics
NPI:1205188463
Name:GOSSES, JESSICA E (LPC)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:E
Last Name:GOSSES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:JESSICA
Other - Middle Name:E
Other - Last Name:GOSSES-HUK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:31-00 BROADWAY
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410
Mailing Address - Country:US
Mailing Address - Phone:201-791-7771
Mailing Address - Fax:201-791-7337
Practice Address - Street 1:31-00 BROADWAY
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410
Practice Address - Country:US
Practice Address - Phone:201-791-7771
Practice Address - Fax:201-791-7337
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-11
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC000434800101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional