Provider Demographics
NPI:1578991303
Name:SANCHEZ, JESSICA HERNANDEZ (LPC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:HERNANDEZ
Last Name:SANCHEZ
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 1:2660 SWEETGUM LN
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77703-4926
Mailing Address - Country:US
Mailing Address - Phone:409-617-9855
Mailing Address - Fax:409-877-1731
Practice Address - Street 1:2660 SWEETGUM LN
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77703-4926
Practice Address - Country:US
Practice Address - Phone:409-617-9855
Practice Address - Fax:409-877-1731
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-14
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10783101YA0400X
TX81792101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX873014688Medicaid