Provider Demographics
NPI:1225386162
Name:SHENESEY, JESSICA (PHD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:SHENESEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 DAUPHIN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36602-3242
Mailing Address - Country:US
Mailing Address - Phone:251-512-5026
Mailing Address - Fax:251-277-2494
Practice Address - Street 1:5 DAUPHIN ST STE 201
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36602-3242
Practice Address - Country:US
Practice Address - Phone:251-512-5026
Practice Address - Fax:251-277-2494
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-27
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1858103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical