Provider Demographics
NPI:1407517527
Name:SIEGFRIED, JESSICCA (LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:JESSICCA
Middle Name:
Last Name:SIEGFRIED
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1053 COUNTY ROAD 155
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-7913
Mailing Address - Country:US
Mailing Address - Phone:956-570-9536
Mailing Address - Fax:
Practice Address - Street 1:1053 COUNTY ROAD 155
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-7913
Practice Address - Country:US
Practice Address - Phone:956-570-9536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-02
Last Update Date:2022-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX82611101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health