Provider Demographics
NPI:1407266299
Name:BROWN, JESSICA MCKLEROY (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:MCKLEROY
Last Name:BROWN
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25112 IVY CHASE
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35613-8443
Mailing Address - Country:US
Mailing Address - Phone:265-434-1085
Mailing Address - Fax:
Practice Address - Street 1:25112 IVY CHASE
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35613-8443
Practice Address - Country:US
Practice Address - Phone:256-434-1085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-01
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC2033A101YM0800X
ALLPC04730101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health