Provider Demographics
NPI:1417548058
Name:HESS, JAMES
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:HESS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1085 ABERLEA VALLEY CIR
Mailing Address - Street 2:
Mailing Address - City:PINEY FLATS
Mailing Address - State:TN
Mailing Address - Zip Code:37686-4361
Mailing Address - Country:US
Mailing Address - Phone:703-774-4369
Mailing Address - Fax:
Practice Address - Street 1:1085 ABERLEA VALLEY CIR
Practice Address - Street 2:
Practice Address - City:PINEY FLATS
Practice Address - State:TN
Practice Address - Zip Code:37686-4361
Practice Address - Country:US
Practice Address - Phone:703-774-4369
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN79101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty