Provider Demographics
NPI:1457850588
Name:JUNG, JESSICA ANN (LPC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:ANN
Last Name:JUNG
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 PARK MEADOW RD STE H
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-2876
Mailing Address - Country:US
Mailing Address - Phone:614-948-3273
Mailing Address - Fax:855-740-2025
Practice Address - Street 1:495 E MOUND ST STE 110
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-5596
Practice Address - Country:US
Practice Address - Phone:614-948-3273
Practice Address - Fax:855-740-2025
Is Sole Proprietor?:No
Enumeration Date:2018-02-05
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.018446225700000X
OHC.2305579101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist