Provider Demographics
NPI:1275150849
Name:FLORES, JESSICA MICHELE (LCAT, LPC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:MICHELE
Last Name:FLORES
Suffix:
Gender:F
Credentials:LCAT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13835 MURPHY HVN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-4563
Mailing Address - Country:US
Mailing Address - Phone:210-710-6803
Mailing Address - Fax:
Practice Address - Street 1:1996 SCHERTZ PKWY STE 501
Practice Address - Street 2:
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154-1677
Practice Address - Country:US
Practice Address - Phone:210-710-6803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-30
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX85995101YM0800X
NY002471-01101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor