Provider Demographics
NPI:1548595077
Name:YEPEZ, JESSICA LUCIA (LICSW)
Entity Type:Individual
Prefix:MISS
First Name:JESSICA
Middle Name:LUCIA
Last Name:YEPEZ
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1443 EUCLID ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-4506
Mailing Address - Country:US
Mailing Address - Phone:301-367-7627
Mailing Address - Fax:
Practice Address - Street 1:1443 EUCLID ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-4506
Practice Address - Country:US
Practice Address - Phone:202-285-1690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-16
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500784321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical