Provider Demographics
NPI:1508374182
Name:JESSICA MORMAN, LMFT, PLLC
Entity Type:Organization
Organization Name:JESSICA MORMAN, LMFT, PLLC
Other - Org Name:HORIZON WELLNESS SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:KYLIE
Authorized Official - Last Name:MORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMFT
Authorized Official - Phone:910-599-1169
Mailing Address - Street 1:108 GILES AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-4759
Mailing Address - Country:US
Mailing Address - Phone:910-769-9691
Mailing Address - Fax:910-239-8373
Practice Address - Street 1:108 GILES AVE STE 102
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-4759
Practice Address - Country:US
Practice Address - Phone:910-769-9691
Practice Address - Fax:910-239-8373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-17
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1513106H00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty