Provider Demographics
NPI:1326337825
Name:CLEVELAND, JESSICA D (MS, LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:D
Last Name:CLEVELAND
Suffix:
Gender:F
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11019 DOVE DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35756-4301
Mailing Address - Country:US
Mailing Address - Phone:256-603-1381
Mailing Address - Fax:
Practice Address - Street 1:9238 MADISON BLVD
Practice Address - Street 2:SUITE 800
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-9100
Practice Address - Country:US
Practice Address - Phone:256-603-1381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-05
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2919101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional