Provider Demographics
NPI:1487197836
Name:SPRENGLE, JESSICA (MA, LPC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:SPRENGLE
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:MELILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LPC
Mailing Address - Street 1:4131 SPICEWOOD SPRINGS RD STE H2
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8659
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4131 SPICEWOOD SPRINGS RD STE H2
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8659
Practice Address - Country:US
Practice Address - Phone:732-707-5377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-01
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00600400101YM0800X
TX79844101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health