Provider Demographics
NPI:1578109799
Name:HOTCHKISS, JESSICA MICHELLE (MS, LAPC, CCLS, NCC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:MICHELLE
Last Name:HOTCHKISS
Suffix:
Gender:F
Credentials:MS, LAPC, CCLS, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4379 33RD AVE S APT 319
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-8642
Mailing Address - Country:US
Mailing Address - Phone:701-200-1414
Mailing Address - Fax:
Practice Address - Street 1:1620 16TH AVE S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-4055
Practice Address - Country:US
Practice Address - Phone:701-809-5370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-22
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1035-11-1-19A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health