Provider Demographics
NPI:1306853973
Name:HUCKSTEP, JESSICA (LMHC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:HUCKSTEP
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8806 PRAIRIE TRL
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-9794
Mailing Address - Country:US
Mailing Address - Phone:317-698-6531
Mailing Address - Fax:
Practice Address - Street 1:8806 PRAIRIE TRL
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-9794
Practice Address - Country:US
Practice Address - Phone:317-698-6531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39001760A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health