Provider Demographics
NPI:1235535923
Name:SCHNELL, JESSICA (LPC, NCSP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:SCHNELL
Suffix:
Gender:F
Credentials:LPC, NCSP
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:PUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4910 GRANDVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82009-4915
Mailing Address - Country:US
Mailing Address - Phone:307-214-6186
Mailing Address - Fax:
Practice Address - Street 1:1600 VAN LENNEN AVE STE 203
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-4636
Practice Address - Country:US
Practice Address - Phone:307-214-6186
Practice Address - Fax:307-263-0498
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-07
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY101Y00000X, 103TC1900X
WYLPC-2091101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling